目的　观察慢性重型病毒性肝炎病程中肝组织学的变化。方法　 2 0 2例慢性重型病毒性肝炎患者在不同病期进行肝穿刺作肝脏病理检查。结果　早、中期肝组织学主要表现为在慢性肝炎和小结节性肝硬变基础上出现大块或亚大块坏死 ;恢复期肝脏以大小结节混合型肝硬变为主 ,少数为重度慢性肝炎的病理表现 ;晚期和死亡者肝组织结构严重破坏 ,肝细胞数量明显减少。结论　慢性重型病毒性肝炎不同病期的组织学各有一定特点。病程中多次肝穿刺对该病病理诊断及预后判断有一定意义。 Objective To observe the changes of liver histology in the course of chronic severe viral hepatitis. Methods Twenty-two patients with chronic severe viral hepatitis underwent liver biopsy at different stages for liver pathology. Results Early and mid-term liver histology was mainly manifested as massive or sub-massive necrosis on the basis of chronic hepatitis and small nodular cirrhosis. In the convalescent stage, the liver was dominated by nodules with mixed nodules and a few with severe Chronic hepatitis pathological manifestations; late and died serious liver tissue damage, a significant reduction in the number of liver cells. Conclusion Chronic severe viral hepatitis has histological features at different stages. Multiple liver puncture during the course of disease pathological diagnosis and prognosis have some significance.