目的观察单纯血浆置换对慢性重型乙型肝炎的治疗效果。方法全部病例内科基础治疗相似 ,治疗组加用血浆置换 ,观察治疗前后临床症状、肝功能指标、凝血酶原活动度、肾功能、血生化指标等。结果治疗组自觉症状较治疗前明显好转 ,总有效率为 93 .75 % ,血清总胆红素、天门冬氨酸转移酶、丙氨酸氨基转移酶等指标明显改善 (P <0 .0 1 ) ,反应肝脏合成功能的指标凝血酶原活动度、胆碱酯酶、总胆固醇等明显升高 ,两组比较有显著差异 (P <0 .0 5)。治疗组在治疗过程中 ,不良反应发生率为 1 2 % ,主要为血浆过敏 ,经对症处理后均缓解 ,未发生过休克、大出血等严重并发症。结论单纯血浆置换可改善慢性重型肝炎患者的临床症状及生化指标 ,降低病死率 ,为肝移植提供有利时机 ,不失为慢性重型肝炎安全有效的支持治疗手段。 Objective To observe the therapeutic effect of simple plasma exchange on chronic severe hepatitis. Methods All cases were treated with similar basic medical treatment. The patients in the treatment group were treated with plasma exchange. The clinical symptoms, liver function indexes, prothrombin activity, renal function and blood biochemical indexes were observed before and after treatment. Results The symptoms in the treatment group were significantly improved compared with those before treatment, with a total effective rate of 93.75%. The levels of serum total bilirubin, aspartate aminotransferase and alanine aminotransferase were significantly improved (P <0.01) ), Indexes of prothrombin synthesis reaction, hepatic cholinesterase, total cholesterol and other indexes were significantly higher in the two groups (P <0.05). The treatment group in the course of treatment, the incidence of adverse reactions was 12%, mainly plasma allergies, after symptomatic treatment were relieved, no severe complications such as shock, bleeding and so on. Conclusion Simple plasma exchange can improve the clinical symptoms and biochemical indexes of patients with chronic severe hepatitis, reduce the mortality and provide a favorable opportunity for liver transplantation, which is a safe and effective supportive treatment for chronic severe hepatitis.