重型病毒性肝炎的临床分型治疗方法及预后分析

Heavy Viral Hepatitis Clinical Parting Treatment and Prognosis of Analysis

目的探讨重型病毒性肝炎的临床分型治疗方法及预后情况。方法选取2009年5月至2011年5月我院收治的140例重型病毒性肝炎患者为研究对象,回顾性分析140例患者的临床资料。结果①重型病毒性肝炎病发年龄主要集中于30-50岁,且年龄与病死率成正比,老年患者病死率高达70%;②单纯HBV感染是重型病毒性肝炎的主要致病原因,占65.7%,病死率为45.7%。重叠病毒感染能明显加重患者病情;③重型病毒性肝炎按照脑病型、腹水型、混合型以及其他型分型,治疗效果有效率差异明显,分别为28.6%、41.1%、11.9%及55.6%;④肝炎治疗中并发症与转归有明显的关联;⑤重型病毒性肝炎患者常伴有胰腺炎（2.1%）、糖尿病（22.1%）及胆结石胆囊炎（27.9%）等。最为常见的并发症为肝性脑病,占55.0%;肝肾综合征,占37.1%;以及电解质紊乱,占46.4%。结论患者年龄、病因、临床类型、并发症以及伴随疾病的有无都会影响重型病毒性肝炎患者转归。

Objective To study the heavy viral hepatitis clinical classification and treatment method and prognosis. Methods The May 2009 to May 2011 were from 140 cases of severe viral hepatitis patients as the research object, the retrospective analysis of the clinical data of 140 patients. Results①The heavy viral ＇flares＇ age mainly focus on 30 to fifty years old, and age and mortality rate is proportional to the elderly patients, mortality rates as high as 70%; ②simple HBV infection is heavy viral hepatitis main causes, accounted for 65.7%, and mortality was 45.7%. Overlap virus infection can obviously increase patient; ~heavy viral hepatitis type, ascites type according to encephalopathy, hybrid and other type of parting, treatment effect efficient have significant difference, respectively is 28.6%, 41.1%, 11.9% and 55.6%; ④complications and outcome in the treatment of hepatitis significant association;⑤heavy viral hepatitis patients often associated with pancreatitis （2.1%）, diabetes （22.1%） and gallstones cholecystitis （27.9%）. The most common complications for hepatic encephalopathy, accounted for 55.0%; hepatorenal syndrome （HRS）, accounted for 37.1%; and electrolyte disorder, accounted for 46.4%. Conclusion The patients＇ age, etiology, clinical types, complications and comorbidity presence will affect the heavy viral hepatitis patient outcome.