目的探讨肝性脊髓病的病因、临床特点、治疗和预后。方法分析28例肝性脊髓病病人的临床资料并复习文献资料。结果男20例,女8例,年龄36￣69岁,平均年龄49岁。其中乙肝肝硬化者17例,丙肝肝硬化者3例,8例为酒精性肝硬化。14例无手术史者在肝硬化失代偿2￣6年发病,14例做过手术者于手术后1￣6年发病。26例的首发症状是双下肢沉重感,2例首发症状为双下肢肌肉发抖。随后患者病情呈缓慢的进行性加重,但病情的进展速度不一。22例检查脑脊液基本正常,9例作肌电图检查,均为上神经元损害改变。26例血氨轻—中度增高。28例经过综合治疗,其中18例肝功能情况好转,肌张力有所减轻,6例治疗后肝功能有所好转,但肌张力情况无变化,4例在治疗过程中死于肝功能衰竭和消化道出血。结论肝性脊髓病的病因仍不明确,临床表现有一定的特征,积极治疗肝性脊髓病的同时更应重视肝硬化的治疗。 Objective To investigate the etiology, clinical features, treatment and prognosis of hepatic myelopathy. Methods The clinical data of 28 patients with hepatic myelopathy were analyzed and reviewed. Results 20 males and 8 females, aged 36 to 69 years, with an average age of 49 years. Among them, 17 were hepatitis B cirrhosis, 3 were hepatitis C cirrhosis, and 8 were alcoholic cirrhosis. 14 cases of non-surgical history of decompensation cirrhosis 2 to 6 years of onset, 14 patients who had surgery in 1 to 6 years after the onset of disease. The first symptom of 26 cases was a severe feeling of both lower extremities, and the first symptom of 2 cases was trembling of both lower limbs. Subsequently, the patient’s condition progressed slowly, but the rate of progression of the disease varied. 22 cases of cerebrospinal fluid examination was normal, 9 cases for EMG examination, are changes in the damage on the upper neurons. 26 cases of blood ammonia light - moderate increase. Twenty-eight patients underwent comprehensive treatment, of which 18 had improved liver function and had reduced muscle tone. Six of them had improved liver function but no change in their muscle tone. Four died of liver failure and digestion during the course of treatment Road bleeding. Conclusions The etiology of hepatic myelopathy is still not clear, and clinical manifestations have some characteristics. Active treatment of hepatic myelopathy should pay more attention to the treatment of liver cirrhosis.