人工肝血浆置换治疗慢性重型肝炎80例临床分析

Clinical Analysis of 80 Patients with Chronic Severe Hepatitis Treated with Artificial Liver(Plasma Exchange)

目的:观察80例经人工肝血浆置换治疗的慢性重型肝炎患者的转归,评价人工肝血浆置换治疗对慢性重型肝炎的临床作用。方法:80例慢性重型肝炎患者在内科综合治疗的基础上予以等量冰冻血浆进行血浆置换(plasma exchange,PE)治疗,观察治疗前后肝肾功能、电解质、血氨、凝血酶原时间、血常规的变化情况。结果:与血浆置换前相比,治疗后患者的血常规、电解质、肾功能无明显变化,总胆红素、血清谷丙转氨酶(ALT)降低(P<0.01),凝血酶原时间缩短(P<0.01),胆碱酯酶升高(P<0.01)。80例慢性重型肝炎患者总死亡率为41.25%。结论:血浆置换是一种有效的人工肝支持疗法,对慢性重型肝炎有肯定和可靠的辅助支持与治疗作用。人工肝治疗进行得越早,疗效越好。掌握好治疗时机是提高疗效的关键所在。

Objective：To evaluate the clinical effects of plasma exchange for treating of chronic severe hepatitis. Methods：Eighty patients with chronic severe hepatitis were treated with plasma exchange using same volume of freeze plasma in addition to the medicine comprehensive treatment. Results： Serum cholinesterase of an patients were in- creased significantly （ P 〈 0.01 ）, while the serum bilirubin, ALT, PT were decreased （ P 〈 0.01 ） than tha before the treatment. The total death rate of 80 patients was 41.25%. Conclusions：The plasma exchange is a kind of effective ar- tificial liver support therapy ,having affirmative and dependable effect of support and treatment in patients with chronic severe hepatitis. The earlier artificial liver treatment carry on, the better curative effect is. The correct opportunity and selection of relevant patients is a key factor that improve the curative effect.