慢性重型肝炎并发症与预后的关系

Relationship Between Complications and Prognosis of Chronic Severe Hepatitis

目的 探讨慢性重型肝炎并发症与预后的关系。方法 对解放军 30 2医院 5 2 0例慢性重型肝炎患者进行回顾性临床分析。结果 慢性重型肝炎最常见并发症是腹水、电解质紊乱及自发性腹膜炎 ,发生率均超过5 0 %。并发症中脑水肿和脑疝预后最差 ,无效和病死发生率为 10 0 %,其次为肝肾综合征、上消化道出血和肝性脑病 ,无效和病死发生率均超过 90 %。随着并发症的增多 ,无效和病死发生率升高。肝性脑病的严重程度与病死率密切相关。结论 有效治疗慢性重型肝炎并发症 ,积极防治并减少严重并发症的发生是降低慢性重型肝炎患者病死率的关键。

Objective To explore the relationship between complications and prognosis of chronic severe hepatitis(CSH).Methods The clinical data of 520 patients with CSH treated in our hospital were retrospectively analyzed.Results The most common complications of CSH were ascites,electrolyte disturbance and spontaneous peritonitis,and their total occurring rate was over 50%.Among all the complications,cerebral edema and cerebral hernia had the worst prognosis,failure in treatment and mortality were 100%.Secondary were followed by hepato-renal syndrome,upper digestive tract hemorrhage and hepatic encephalopathy that resulting to effectless rate and mortality of 90% .The effectiveless rate and mortality rose along with increase in number of complications .Meanwhile,the severity of hepatic encephalopathy was closely related to mortality in the patients.Conclusions Effective treatment of complications of CSH and reduction of occurring rate of the complications are very important for decreasing mortality of patients with CSH.