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目的：观察脐血干细胞移植治疗失代偿期肝硬化的临床疗效。方法：对60 例失代偿期肝硬化患者进行自身对照的临床研究。在无菌条件下取健康产妇足月生产的脐带血，分离纯化脐血干细胞，通过肝动脉途径，将纯化的脐血干细胞移植入患者肝脏内，于移植后2 周、4 周、8 周进行肝功能、凝血指标检测，并于4 周及8 周行腹部B 超及胃镜检查，观察患者移植后不同时间症状改善情况及术后不良反应的发生情况。结果：60 例接受脐血干细胞移植的肝硬化患者术中术后无明显不良反应发生。移植后，患者临床症状改善明显，食欲不振、乏力、腹水等减轻甚至消失；血清学检测：白蛋白水平较术前明显升高，凝血酶原时间、总胆红素较术前明显下降；术后8 周复查胃镜，食道静脉曲张没有明显变化。结论：脐血干细胞移植治疗失代偿期肝硬化是一种安全、有效的方法，尤其是在提高白蛋白水平及改善凝血功能方面有很好的疗效，可作为肝移植治疗的过渡或补充治疗。

英文摘要:

Objective: To investigate the clinical therapeutic effect of umbilical blood stem cell transplantation on patients with decompensated liver cirrhosis. Methods: By using self-controlled, 60 cases of patients with decompensated cirrhosis were studied. Umbilical cord blood was collected from mature fetuses delivered by healthy parturient women under sterile conditions. Stem cells were separated and were transplanted into a patient's liver through the hepatic arteries. At different time (2, 4 and 8 wk) after transplantation, liver function and coagulation index tests were performed. Abdominal ultrasounds and gastroscopes were obtained 4 and 8 wk after the operation. Changes and adverse reactions in the 60 patients were observed. Results: No remarkable side effect was discovered in all 60 patients. Their clinical symptoms, such as poor appetite, physical weakness, and peritoneal dropsy were either relieved or entirely disappeared. Albumin levels increased and total bilirubin remarkably decreased. No evident change took place in the esophagus varix based on the gastroscopy performed 8 wk post-transplant. Conclusions: CBSCT is a safe and effective therapy for decompensated hepatocirrhosis. Albumin levels and liver coagulation capacity are improved. CBSCT can serve as an alternative or a supplement to liver transplantation.

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