重型病毒性肝炎分期多环节药物治疗效果比较

Comparative study of multiple link drug therapy for severe viral hepatitis

目的探讨重型病毒性肝炎分期多环节药物治疗效果。方法依据重型病毒性肝炎的发病机理进行分期多环节药物综合治疗、在病程早期，采用抑制强烈的免疫反应、阻断肠源性内毒素血症和以肿瘤坏死因子为核心的细胞因子网络、改善肝内微循环、保护肝细胞、消除反应氧中间产物、促进肝细胞再生及高价营养疗法；在病程中晚期，禁用免疫抑制剂。用本方案治疗了321例重型病毒性肝炎。结果重型病毒性肝炎早期病例的治疗有效率（84．21％）明显高于中期（55．55％）和晚期（8．77％）病例（P值均＜0．005），中期病例亦明显高于晚期病例（P＜0．005）．结论对重型病毒性肝炎进行分期多环节药物治疗是合理和必要的。在重型肝炎早期进行积极救洽，防止向中晚期发展，可显著降低重型肝炎的总体病死率。报告分期治疗效果有利于各家报道之间的比较。

To explore the efficacy of multiple link drug comprehensive therapy treatment in severe viral hepatitis. Methods According to the pathogenesis of severe viral hepatitis, a new multiple link drug comprehensive therapy was adopted. In early stage of the disease, depressing enhanced immune reaction, blocking enterogenous endotoxemia and cytokine network especially tumor necrosis factor, improving intrahepatic inicrocirculation, proterting hepatocyte, inhibiting reactive oxygen intermedate , promoting hepatocyte regeneration and intravenous high value nutrition therapy were uSed. In middle and late phase of the disease, the immunosuppressive agents were prohibited to use. 321 patients with severe viral hepatitis were treated with above methods. Results The efficiency rate of early stags cases (84.21%) was significantly higher than in middle stags cases (55.55%) and late stage cases (8.77%) (P<0.005); and in middle stage cases was significantly higher than in late stage cases also(p<0.005). Conclusion The multiple link drug comprehensive therapy is reasonable and essential in the treatment of severe viral hepatitis. In early stage of the disease, active treatment may prevent developing to middle and fate stages,and cause the total mortality of severe viral hepatitis to decrease. Reporting different Stage efficiency rate may be benefitial to compare reported results of different papers. [