摘要
目的:探讨内科综合疗法联合血浆置换治疗慢性重症肝炎肝功能衰竭的疗效及安全性。 方法:对照组为内科综合治疗的44例慢性重症肝炎肝功能衰竭患者,治疗组为内科综合治疗联合人工肝-单纯膜式血浆置换(PE)治疗的41例病情相同患者。检测PE治疗前后患者临床症状、肝功能、凝血酶原活动度(PTA)、血氨(NH3)等指标的变化;观察治疗的不良反应及安全性。 结果:治疗组治愈好转30例(73％),未愈死亡11例(27％),对照组治愈好转23例(52％),未愈死亡20例(48％)。PE治疗后患者乏力、纳差、恶心、腹胀等临床症状明显缓解,肝功能明显好转(P<0.001),血清总胆红素(T-Bil)由平均461μmol/L降低至146μmol/L,凝血酶原活动度(PTA)提高24.3％。治疗过程中发生不良反应13例次(15％),经对症处理均能缓解。治疗后1mo随访,无1例发生其他病毒重叠感染。 结论:联合血浆置换疗法,能显著改善慢性重症肝炎肝功能衰竭患者的临床症状及肝脏生化指标,提高存活率,且安全可行。
AIM: To evaluate the therapeutic effect and safety of complex treatment with plasma exchange (PE) on patients with chronic severe hepatitis and hepatic failure.METHODS: Comparison of therapeutic effect was made between complex treatment with PE group ( n = 41) and without PE group ( n = 44) in patients with chronic severe hepatitis and hepatic failure. The changes of clinic symptom, liver function and serum PTA were observed before and after treatment, and the treatment related side effects were recorded as well.RESULTS: In treatment group, 30 cases were cure or improved (73 %), and 11 died (27 %); but in control group 23 were cure or improved (52 %), and 21 died (48 %). Hepatic function was improved obviously after PE, in which Bil was fell down from 460.8 μmol/L to 146.3 μmol/L (P< 0.001), and the PTA was increased from 23 % to 48 % (P < 0.001). 13 cases had side effects (16 %) that were slight and reversible after treatment.CONCLUSION: Complex treatment with PE can improve the recovery rate and reduce mortality in patients with chronic severe hepatitis. These results suggest that PE is effective and safe in treatment of chronic severe hepatitis and hepatic failure.
出处
《世界华人消化杂志》
CAS
2002年第6期638-641,共4页
World Chinese Journal of Digestology
