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肝病专科医院10年来住院病人疾病谱变化的调查
作者:沈玲 赵伟 舒伟平 袁春蓓 高金荣 徐永林 
单位:东南大学医学院,附属南京第二医院,江苏,南京,210003
关键词:病毒性肝炎 肝硬化 肝癌 肝病 调查 
分类号:R575, R735.7
出版年·卷·期(页码):2004·23·第二期(99-103)
摘要:

目的:了解肝病专科医院10年来住院病人疾病谱的变化,分析肝癌病例的某些危险因素,期望在肝病高危人群中早期诊断肝癌.方法:对住院的25 840例肝病病人进行回顾性调查.结果:(1)25 840例肝病住院病人中男性占83.54%,女性占16.46%;其中急性肝炎占41.55%,慢性肝炎占30.62%,肝硬化占22.08%,肝癌占5.75%.(2)青年组慢性肝炎比例上升占同病种病人的68.48%(5 419/7913),中年组肝硬化比例占同病种病人的54.34%(3 100/5705),老年组肝硬化、肝癌的比例均较高,其肝癌占所有肝癌病例的21.00%.(3)前后5年收治疾病谱比较:近5年急性肝炎收治数下降,慢性肝炎、肝硬化在上升,肝癌的比例亦在上升.结论:肝病医院中,中青年慢性肝炎、肝硬化乃至肝癌的收治率在上升.应在传染病医院开展对慢性肝炎,尤其是肝硬化病人的跟踪监测和预防,以期能早期发现和诊断肝癌.对中青年组慢性肝炎病人应及早进行抗病毒和抗肝纤维化治疗,阻断慢性肝炎向肝硬化、肝癌发展的过程.

Objective  To investigate the change in spectrum of inpatients with hepatic diseases in hepatic hospital,to analyze the critical causes of the diseases,and to diagnose the liver cancer in patients with high likelihood in the early stage.Method  25?840 inpatients with hepatic diseases were reviewed.Results  (1)There are men (  83.54%  ) and women (16.46%) of 25?840 inpatients with hepatic diseases,among whom 41.55% suffered acute hepatitis,  30.62%   chronic hepatitis,22.08% hepatic cirrhosis,5.75% liver cancer,respectively.(2)The rate of youth patients with chronic hepatitis raised to 68.48%(5?419/7?913).The proportion of middle aged patients with acute hepatitis obviously reduced,while that with hepatic cirrhosis quickly elevated to 54.34%(3?100/5?705).The proportion of elderly patients with hepatic cirrhosis or liver cancer is higher,in which are 21.00% with liver cancer.(3)Compared with the spectrum of hepatic diseases during the last five years,the number of patients with acute hepatitis reduced,that of chronic hepatitis,hepatic cirrhosis and liver cancer kept rising,and the proportion of liver cancer was rising.Conclusion  In hepatic hospital,the number of youth and middle aged patients with chronic hepatitis,hepatic cirrhosis and liver cancer are quickly increasing.Patients with chronic hepatitis should be monitored,so that the liver cancer are found out and diagnosed in the early stage.The youth and middle aged patient with chronic hepatitis should be treated with anti  viral and anti  fibrotic medicine,to hold up the development from chronic hepatitis to hepatic cirrhosis or liver cancer.

参考文献:

[1] 骆抗先. 乙型肝炎基础和临床, 1999
[2] 沈玲, 薛林, 端木浩. 560例原发性肝癌临床分析, 1999(1)
[3] 华玉瑾, 何兆年, 吴卉. 乙肝与肝癌发病的多因素临床研究, 1993(7)
[4] FURUAL T, KANEMATSU T, Matsumata T. 3.0.CO, 2-T.aspx">Clinicopathogic teatures of hepatocellular carcinoma in young patients. 1990. doi:10.1002/1097-0142(19901201)66:11&lt, 2395::AID-CNCR2820661125&gt, 3.0.CO, 2-T
[5] 蔡积武, 林正理. 青、中、老年原发性肝癌致癌因素探讨, 1997(1)  

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