人工肝血浆置换治疗重型肝炎的临床疗效

Clinical effects of artificial liver plasma exchange in the treatment of severe hepatitis

目的观察人工肝血浆置换治疗重型肝炎的临床疗效及安全性。方法将128例重型肝炎患者随机分2组,治疗组64例,在内科综合治疗基础上,给予人工肝血浆置换治疗;对照组64例只予内科综合治疗,观察治疗前后2组的临床症状、血生化指标、不良反应及转归情况。结果治疗组,血浆置换治疗后,患者的临床症状均有不同程度的减轻,精神、食欲好转,乏力及腹胀明显改善,血生化ALT、TBiL、血氨数值下降较显著。对急性、亚急性、慢性重型肝炎合并肝性脑病,治疗组治愈好转率分别为66.7%,78.6%,41.7%;对照组为16.7%,18.2%,15.4%,2组比较有非常显著性差异(P<0.01)。结论人工肝血浆置换可显著改善患者的临床症状及血生化指标,特别对重型肝炎合并肝性脑病者疗效佳,安全性好。

Objective To study the clinical effect and safety of artificial liver plasma exchange in the treatment of severe hepatitis.Methods The 128 patients with severe hepatitis were divided into two groups in random：the trial group and control group.There are 64 patients in every group.The trial group was treated with the artificial liver plasma exchange on the basis of medical therapy.The control group was treated with basis of medical therapy.The change of clinical symptom,biochemistry index,adverse reactions and prognosis were observed.Results The patients in the trial group were obviously improved on the clinical symptom,liver function.The blood biochemical indexes（ALT、TBiL）was decreased.The cure rate of the acute,sub,acute and chronic severe hepatitis in the trial group were 66.7%,78.6%,41.7%;but in the control group were 16.7%,18.2%,15.4%,respectively.There was significantly on the cure rate in two groups（P0.01）.Conclusion The patients who were treated with the artificial liver plasma exchange on the basis of medical therapy were relieved in blood biochemical.Artificial liver plasma exchange can significantly improve clinical symptoms,especially for severe hepatitis with hepatic encephalopathy treatment effect,good safety.