目的探讨肝性脊髓病(HM)的临床特点及治疗方法。方法对12例确诊HM患者的临床资料进行回顾性分析。结果12例患者均具有典型的痉挛性截瘫的临床表现;4例(33.3%)曾接受门腔静脉分流术;10例(83.3%)血氨轻中度增高,血氨检测正常者2例(16.7%);10例(83.3%)内科治疗无明显效果。结论HM患者以痉挛性截瘫为主要表现,血氨增高可能不是惟一致病因素,常规内科治疗效果不佳,肝移植为HM的治疗带来希望。 Objective To investigate the clinical features and treatment of hepatic myelopathy (HM). Methods The clinical data of 12 patients with confirmed HM were retrospectively analyzed. Results All the 12 patients had the typical clinical manifestations of spastic paraplegia. Four cases (33.3%) had received portal venous shunt, 10 (83.3%) had moderate increase of blood ammonia, 2 had normal blood ammonia test 16.7%); 10 cases (83.3%) no significant effect of medical treatment. Conclusion The main manifestations of spastic paraplegia are HM patients. The increase of blood ammonia may not be the only risk factor, and the conventional medical treatment is not effective. Hopefully, the treatment of HM with liver transplantation will be hopeful.