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目的评价中间型人工肝支持系统——血浆置换治疗慢性重型肝炎的临床疗效和安全性及血浆置换首次效应与预后关系。方法对106例慢性重型肝炎患者进行血浆置换治疗,观察第一次置换前后患者临床症状变化,比较治疗前后血红蛋白,谷丙转氨酶,白蛋白,球蛋白,总胆红素,凝血酶原变化。结果血浆置换后,患者的临床症状均有不同程度缓解,有效率达70.7%,最终存活率45.3%。谷丙转氨酶,总胆红素,白蛋白,球蛋白,凝血酶原时间和血红蛋白置换前后差异均有显著性(P<0.05或P<0.01)。好转组与恶化组首次置换后总胆红素下降幅度,PT缩短程度亦有显著性差异(P<0.05或P<0.01)。结论中间型人工肝支持系统———血浆置换对慢性重型肝炎患者临床症状,肝功能均有改善,首次置换效果佳者,预后好,生存率提高。
Objective To evaluate the clinical efficacy and safety of intermediate artificial liver support system-plasmapheresis in the treatment of chronic severe hepatitis and the relationship between the first-time plasmapheresis and prognosis. Methods 106 patients with chronic severe hepatitis were treated with plasma exchange. The changes of clinical symptoms before and after the first replacement were observed. The changes of hemoglobin, alanine aminotransferase, albumin, globulin, total bilirubin and prothrombin were compared before and after treatment. Results After plasma exchange, the clinical symptoms of patients were relieved to varying degrees, the effective rate was 70.7% and the final survival rate was 45.3%. There were significant differences in alanine aminotransferase, total bilirubin, albumin, globulin, prothrombin time and hemoglobin before and after the replacement (P <0.05 or P <0.01). There was also a significant difference in the decrease of total bilirubin and shortening of PT after the first replacement in the improved group and the worsened group (P <0.05 or P <0.01). Conclusion The intermediate artificial liver support system --- plasma exchange has the clinical symptoms and liver function improvement in patients with chronic severe hepatitis. The first replacement effect is good, the prognosis is good, and the survival rate is improved.