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目的 研究重型病毒性肝炎 (重肝 )的并发症及影响预后的主要因素。方法 对 116例重肝的有关临床资料进行统计分析。结果 116例重肝有 88例 (75 9% )存在并发症 ,常见的依次为肝性脑病 (6 8 1% )、上消化道出血 (5 4 2 % )、感染 (48 3% )及肝肾综合征 (31 9% )。存在并发症组死亡率 (80 7% )明显高于无并发症组(14 4% ) ,P <0 0 1,出现肝肾综合征及 3个以上并发症者全部死亡。血清总胆红素越高 ,凝血酶原活性越低、总胆固醇越低 ,其病死率越高 ,甲胎蛋白 (AFP)升高者 ,预后较好。结论 重肝的预后与并发症的出现、总胆红素水平、凝血酶原活性、总胆固醇、甲胎蛋白有关。
Objective To study the complication of severe viral hepatitis (severe liver) and the main factors affecting the prognosis. Methods The clinical data of 116 cases with severe liver were statistically analyzed. Results A total of 116 cases of severe hepatitis were found in 88 cases (75.9%) with complications of hepatic encephalopathy (68.1%), upper gastrointestinal bleeding (54.2%), infection (48.3%) and liver Renal syndrome (31 9%). The complication mortality (80.7%) was significantly higher than that of the non-complication group (14.4%), P <0.01, and all the complications of hepatorenal syndrome and all three complication died. The higher the serum total bilirubin, the lower the prothrombin activity, the lower the total cholesterol, the higher the mortality and the higher the AFP, the better prognosis. Conclusion The prognosis of severe hepatitis is related to the occurrence of complications, total bilirubin level, prothrombin activity, total cholesterol and alpha-fetoprotein.