血浆置换联合血浆灌流治疗慢性肝炎重度黄疸临床观察

Clinical observation of plasma exchange and plasma perfusion on treating chronic hepatitis patients with severe jaundice

目的探讨血浆置换+血浆灌流(PE+PP)治疗慢性肝炎重度黄疸的疗效及临床价值。方法对青岛市传染病医院血液净化中心72例慢性肝炎重度黄疸患者随机分为治疗组和对照组,对照组35例患者只给予综合治疗,治疗组37例患者在综合治疗的基础上给予(PE+PP)治疗,并分别观察2组治疗前后症状、体征、肝功能、PTA、血常规、电解质及(PE+PP)治疗中并发症的发生;检测治疗后2周、4周的肝功能、PTA等并追踪近期转归。结果治疗组经(PE+PP)治疗后肝功能改善明显,PTA明显上升。治疗后2周、4周较治疗前,治疗组TBil下降明显(P<0.01),PTA上升明显(P<0.05)。治疗组治愈好转率89.2%,对照组治愈好转率71.4%,疗效比较差异明显(P<0.01)。结论(PE+PP)治疗慢性肝炎重度黄疸患者能显著改善肝功能,阻止病情恶化,明显提高临床治愈好转率。

Objective To study the therapeutic effect of plasma exchange and plasma perfusion （PE＋PP） on chronic hepatitis patients with severe jaundice. Methods Seventy two patients with severe jaundice were divided into two groups randomly. In the treating group, the patients were treated with （PE＋PP） on the basis of the conventional therapy, but the control group received the conventional therapy only. The main symptoms, liver function, prothrombin activity（PTA） before and 2 weeks, 4 weeks after treatment, were observed. Results After treating with （PE＋PA）, the liver function were ameliorated. The prothrombin activity increased significantly. 2 weeks, 4 weeks after treatment, the level of total bilirubin decreased markedly （P〈：0.01）, the prothrombin activity increased significantly（P〈0. 05）. The total effective rate in the treating group was 89.2%, while 71.4% in the control group. There were significant differences between the two groups（P〈0.01）. Conclusion Artificial liver support system can ameliorate the liver function of chronic with hepatitispatients severe jaundice. It can also increase the survival rate.