血浆交换治疗慢性重型肝炎

Use of Artificial liver System in the Treatment of Chronic Severe Hepatitis

目的 :探讨人工肝支持系统治疗慢性重型肝炎的疗效、安全性。方法 :选取 4 0例慢性重型肝炎患者 ,入院后给予内科综合治疗 ,在内科综合治疗的基础上加用人工肝支持治疗。观察治疗组的存活率 ,每次治疗前后的肝肾功能、凝血因子 V、补体 C3 、血氨、血浆内毒素及 WBC、RBC、PLT的变化 ,并观察人工肝治疗过程中的副反应及患者治疗前后的临床症状、体征的变化。结果 :治疗组存活率为 5 0 % ,治疗组每次治疗前后肝功能明显改善 ,凝血因子 ,补体 C3 明显上升 ,血氨、内毒素浓度显著下降 ,治疗前后 RBC、WBC、PLT无明显变化。治疗组部分患者在治疗中有荨麻疹、口唇麻木等副作用 ,但不影响治疗的进行 ,治疗后患者的临床症状、体眚好转。结论 :人工肝治疗较显著提高患者的存活率 ,副作用小 ,安全性高。人工肝治疗能明显改善患者的肝功能 ,清除患者体内的血氨、内素素等有害物质 ,补充凝血因子、补体、白蛋白等生物活性物质 ,为患者的自然恢复争取机会。

Objective To evaluate the efficacy and the safety of artificial liver support system(ALSS) in the treatment of chronic severe hepatitis.Methods:40 patients with chronic severe hepatitis were treated with ALSS.Survival rates have been investigated.The liver function,renal function,ammonia,endotoxin level,coagulation factor V and complment C 3 were detected before and after every treatment with ALSS.Furthermore,we observed the side-effect during the treatment.Result:The survival rate is 50%.The liver function is significantly improved.The liver function,the concentration of ammonia,endotoxin improved significantly after every treatment.Coagulation factor V and complement C 3 increased markedly after every treatment.Urticaria is a dominant side-effect during the treating of ALSS.Conclusions:The ALSS is effective and safe in treating chronic hepatitis.It has the effect of removing the toxic elements within the blood which the damaged liver fails to metabolize,and its also substitute albumin,blood coagulation factors and complement molecules.