摘要
目的:观察血浆置换联合大黄灌肠治疗重型肝炎合并肝肾综合征的疗效及安全性。方法:将收治的76例重型肝炎患者分为两组,A组40例,给予常规内科治疗加人工肝血浆置换术;B组36例,在A组治疗基础上联合大黄煎剂灌肠治疗。观察治疗前后两组患者的症状、体征、尿量及血清总胆红素(TB)、谷丙转氨酶(ALT)、白蛋白(ALB)、凝血酶原活动度(PTA)、尿素氮(BUN)、肌酐(Cr)、血清钾离子(K+)浓度等指标的变化并与健康体检组30例(C组)肾功能、血清钾对比,同时比较治疗2周后的疗效。结果:B组治疗后肝、肾功能及电解质改善优于A组(P<0.05或P<0.01),肾功能、血清钾与C组比较,差异无统计学意义(P>0.05),治疗2周后两组患者症状、体征均比治疗前改善,B组总有效率为80.6%,A组总有效率为57.5%,两组比较,差异有统计学意义(χ2=4.661,P<0.05)。结论:血浆置换联合大黄灌肠治疗重型肝炎合并肝肾综合征安全有效。
Objective： To observe the efficacy of plasma exchange（PE） combined with Rhubarb enema in treatment of patients with severe hepatitis accompanied with hepatorenal syndrome.Methods： 76 cases of patients with severe hepatitis accompanied with hapetolenal syndrome were divided into group A（40 cases） and group B（36 cases）.All patients of group A and B were treated with common medical treatment and PE.Patients in the group B were treated by Rhubarb enema based on group A.The change of symptom,sign,urine volume,TB,ALT,ALB,PTA,BUN,Cr and K＋ before and after treatment were observed and BUN,Cr and K＋ of the two groups were compared with those of the healthy persons（group C,30 cases）.The efficacy of group A and B were compared after treatment two weeks.Results： After treatment,the TB,ALT,ALB,PTA,BUN,Cr and K＋ of group B improved obviously than those of group A（P〈0.05 or P〈0.01）.There was no significant difference of the BUN,Cr and K＋ between group B and C（P〉0.05）.The symptom,sign,urine volume of the group A and group B were improved after two weeks treatment,the total efficiency of group B was 80.6%,that of group A was 57.5%,and there were significant differences between them（χ2=4.661,P〈0.05）.Conclusion： PE combined with Rhubarb enema can safely and effectively treat severe hepatitis accompanied with hepatorenal syndrome.
出处
《中国医药导报》
CAS
2011年第28期34-36,共3页
China Medical Herald
基金
右江民族医学院科研资助项目(编号:右科一般0802005)
关键词
重型肝炎
肝肾综合征
血浆置换
大黄
灌肠
Severe hepatitis
Hepatorenal syndrome
Plasma exchange
Rhubarb
Enema
