453例病毒性重型肝炎的临床特征及其防治意义

Clinical Features of Severe Viral Hepatitis and Their Significance

本文453例重肝中,急性重型40例(8.8％),亚急性重型413例(91.2％)。乙肝总感染率为78.4％,非甲非乙型为19.6％。肝中HDAg阳性检出率为4.8％(5/104例),其中上海、天津和沈阳地区分别为4.5％、11.5％及1.7％。 324例有肝性脑病。Ⅰ°—Ⅳ°肝性脑病者病死率分别为0％、15.2％、42.9％及83.8％。凝血酶原活动度>60％、30％～60％和<30％患者的病死率分别为0％、20.1％及57.8％。常见并发症为出血(53.2％)、继发性感染(33.8％)及肝肾综合征(15.0％)。对采用的六种新疗法疗效作了初步评价。

In 453 patients with viral severe hepatitis (SVH), acute SVH and subacute SVHaccounted for 8.8% and 91.2% respectively. Total infectious rate for HBV was78.4% and the rate for Non-A, Non-B was 19.6%. The positive rate of hepatitis Dantigen in the liver was 4.8%. 307 of the 453 patients had hepatoencephalopathy.The mortality rates of the patients with hepatocoma from one to four grade were0%, 16.9%, 41.5%, and 90.1% respectively. Prothrombin activity correlated inverselywith the death rate of SVH patients. Essential complications included hemorr-hage, secondary infection and hepatorenal syndrome. Six new therapeutic methodswere used in these cases.