Inui Shigeki, Harada Toshiko, Nakajima Takeshi, Itami Satoshi
Department of Regenerative Dermatology, Osaka University Graduate School of Medicine, Osaka, Japan.
J Dermatol. 2007 Jun;34(6):400-2. doi: 10.1111/j.1346-8138.2007.00298.x.
We report two cases of pressure ulcers in liver cirrhosis patients. In case 1, a 64-year-old Japanese woman had suffered from liver cirrhosis caused by hepatitis C virus and developed a pressure ulcer on her sacral and coccygeal area due to long-term bedrest. After she received a living donor liver transplantation from her child, the ulcer healed synchronizing with improvement of serum cholinesterase and bilirubin. Likewise, her systemic condition also got much better after the transplantation. In case 2, a 53-year-old Japanese man with hepatitis B virus cirrhosis and hepatocellular carcinoma developed a pressure ulcer on his sacral area. Although he received a living donor liver transplantation from his brother, his general status and pressure ulcer were fluctuating in conformity with the variance of serum bilirubin. However, at 5 weeks after the transplantation, the ulcer gradually started improving, entrained to serum bilirubin decrease. From these findings, the condition of the pressure ulcer in liver cirrhosis patients synchronized with serum bilirubin as well as systemic condition, suggesting a possible influence of bilirubin for wound healing.
我们报告了两例肝硬化患者发生压疮的病例。病例1中，一名64岁的日本女性因丙型肝炎病毒导致肝硬化，由于长期卧床，在骶尾部出现了压疮。在接受了来自其子女的活体供肝肝移植后，溃疡随着血清胆碱酯酶和胆红素的改善而愈合。同样，移植后她的全身状况也有了很大改善。病例2中，一名53岁患有乙型肝炎病毒肝硬化和肝细胞癌的日本男性在骶部出现了压疮。尽管他接受了来自其兄弟的活体供肝肝移植，但其总体状况和压疮随着血清胆红素的变化而波动。然而，移植后5周，溃疡随着血清胆红素的下降逐渐开始好转。从这些发现来看，肝硬化患者压疮的状况与血清胆红素以及全身状况同步，提示胆红素可能对伤口愈合有影响。
