活性炭血液灌流联合血液透析在重型病毒性肝炎中的临床应用

The clinical application of hemoperfusion with activated charcoal combmed with hemodialysis in severe hepatitis

目的 观察活性炭血液灌流联合血液透析治疗重型病毒性肝炎的治疗效果。方法 随机抽取符合病例选择标准的22例患者为治疗组,30例患者为对照组,两组均采用常规方法治疗,而治疗组同时加用活性炭血液灌流联合血液透析。结果 治疗组22例患者共计进行活性炭血液灌流联合血液透析58例次,治疗后完全改善5例,好转6例,有率达50％,中断治疗3例,死亡8例。结论 活性炭血液灌流联合血液透析治疗重型病毒性肝炎是一种重要的人工肝支持疗法,应用活性炭血液灌流联合血液透析治疗重型病毒性肝炎可明显提高疗效,两组比较有效率、死亡率差异显著。但需掌握适当的治疗时机及适应症,针对血小板减少、凝血酶原时间延长等出血危险因素给予及时对症处理。

Objective To observe the effect of hemoperfusion with activated charcoal combined with hemodialysis on serious virus hepatitis. Methods Twenty - two patients were chosen as treating group and 30 patients as control randomly. Both of them were treated with routine methods whereas the treating group was given hemoperfusion with active charcoal combined with hemodialysis.Results Among the treating group, 22 cases accepted this treatment up to 58 times, 5 cases were cured, 6 cases were improved, the efficiency was about 50% , 3 cases were stopped and 8 cases were dead. Conclusions The method to cure the serious virus hepatitis by means of hemoperfusion with active charcoal combined with hemodialysis is an important treatment of Artificial Liver Support. It can improve the efficiency obviously. Compared with the two groups above, they differ from each other in efficiency rate and mortality rate significantly. Meanwhile , we must choose the proper opportunity of the treatment and the relative indications in advance. We should deal with risk factors of bleeding, such as declining of platelet and the plongation of prothrombin time.