血浆置换治疗慢性重型乙型肝炎的临床分析

Clinical Analysis of Impact of Plasma Exchange on Chronic Severe Hepatitis B

目的观察血浆置换(PE)治疗慢性重型乙型肝炎的疗效。方法选择天津塘沽传染病医院31名慢性重型乙型肝炎住院患者,均在内科综合治疗基础上联合PE治疗。观察治疗前、后临床症状及生化指标变化、死亡率及不良反应。结果与PE治疗前相比,治疗后中毒症状明显改善,TB、ALT、PTA、NH3下降明显(P<0.01),Ca降低(P<0.05),肾功能(BUN、Cr)、电解质(K、Na)、ALB、无显著变化。31例患者总死亡率为45.16%,无严重的不良反应。结论PE是一种安全有效的治疗方法,对慢性重型乙型肝炎有肯定和可靠的辅助支持与治疗作用,联合内科基础治疗既可以改善重型病毒性肝炎患者的肝功能和凝血功能状态,维持内环境稳定,又可以提高存活率,降低死亡率,是一种值得更深入研究的新方法。

Objective To study the efficacy of plasma exchange （PE） in the treatment of chronic severe hepatitis B. Methods Thirty- one of those suffering from chronic severe hepatitis B received plasma exchange combined with comprehensive treatment . Results The serum billrubin , ALT , PTA , NH3 , Ca were decreased （ P 〈 0. 01, P 〈 0.05） compared with that before treatment . Total death rate was 45.16%. There appeared no severe adverse reactions. Conclusion PE is one kind of safe and effective artificial supporting regime. Combined with other basic therapy of PE is valuable to improving serious toxic hepatitis patient＇ s liver function and enhancing the survival rate, which is the very subject deserving further study and efforts.