| Summary: To study the clinical efficacy in patients with decompensated cirrhosisautologous BMSC (bone marrow stem cell) therapy.Methods: Choose80patients with liver cirrhosis from2011at the GeneralHospital of Shenyang Military Region, Department of Gastroenterology, they all aged26to71years old，the mean age was53±14years old, posthepatitic cirrhosis of theliver are72patients, alcoholic cirrhosis were5patients,3patients were primarybiliary cirrhosis. Preoperative abdominal CT examination and alpha-fetoprotein mayexclude primary liver cancer.In a sterile environment, the use of bone marrow needle biopsyand extraction of180-200mL of iliac bone marrow injection bags, for separation and purificationof bone marrow stem cells in vitro, via hepatic artery after injection of the liver. Regulardetection of liver function and blood coagulation function after surgery for the sameperiod and observe the signs and symptoms of adverse reactions, in2,4,8weeks aftertransplantation of the patient’s liver function, prothrombin time (PT) to evaluate, beforeand after transplantation of liver any serious adverse effects occur, and record thepatients survival rate and symptoms.Results: Serum biochemical parameters in patients with autologous bone marrowstem cell transplantation after2weeks after the start of change, compared with the preoperative serum albumin in patients compared to the line increased significantly (P<0.01) from the previous bone marrow hepatocyte transplantation, from preoperative30.90±5.50g/L gradually increased to35.65±5.57g/L, alanineaminotransferase decreased (P <0.01),/L gradually decreased from an average of81.08±31.35U preoperatively to74.15±9.24U/L, aspartate aminotransferasedecreased (P <0.05), the mean preoperative69.62±42.21U/L decreased to60.63±19.89U/L, prothrombin time was significantly decreased (P <0.01), decreasedfrom an average of15.40±2.86s preoperatively to14.05±3.58s, fibrinogen alsoincreased significantly (P <0.01), from an average3.13±0.78g/L increased to3.57±0.83g/L, TBIL downward trend, but the difference was not statisticallysignificant (P>0.05). Liver function parameters were significantly improved inpatients, but the index changes were not significant jaundice. Observed one weekafter transplantation, the appetite to improve or upgrade74patients (92.0%),perceived physical improvement of71patients (85.6%), there is one case observed asignificant reduction in the spider telangiectasia, liver disease accounted for65.7%ofthe face to improve the total survival rate of63.6%, which tracked patient survivalwas observed in2patients transplanted in the first two weeks of death, cause of deathwere complications of liver failure due to chronic spontaneous bacterial peritonitis orhepatorenal syndrome or DIC.2patients after transplantation low fever symptoms, notreatment may be within24hours of spontaneous remission, and another6patientsperceived slight nausea, not spit, but clinically symptomatic treatment will be given,can significantly alleviate the symptoms of nausea and better. All patients no case ofcell transplantation complications.Conclusion: Combines data analysis will be observed after autologous bonemarrow stem cell transplant albumin index increased significantly, FIB, PT, ALT andAST have significantly reduced, TBIL no significant change, indicating that patientswith postoperative liver function, Child-Pugh score and clinical symptoms improvedto a certain extent, to fully enhance the quality of life in patients with cirrhosis.Treatment is based on current clinical symptoms of cirrhosis, liver protective and conservative treatment, poor treatment, is currently on the end-stage cirrhosis, the lackof specific clinically effective treatment, although currently the best treatment isorthotopic liver transplantation However, currently there exists orthotopic livertransplantation liver sources are scarce, patients generally can not afford its high costof surgery, and transplant rejection after liver transplantation, and many thornyproblems, which greatly limits the liver transplant is widely used in clinical, comparedwith liver transplantation, autologous bone marrow stem cell transplantation in thetreatment of liver cirrhosis without immune rejection does not involve ethical issuesand low cost, the process is relatively simple surgical procedure, there is nopostoperative complications such as liver transplant rejection, the autologous bonemarrow stem cell transplant safe and effective treatment for end-stage liver disease andliver function and blood coagulation was observed in patients improved significantly,but also improved quality of life, due to the small sample size, short follow-up time,pending further studies with larger sample to prove efficacy in clinical trials and shouldbe strictly controlled indications. |
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