全结肠透析对慢性重型肝炎严重并发症的干预研究

目的：观察全结肠透析治疗机对慢性重型肝炎严重并发症的干预作用。方法：采用JS-308型全结肠透析治疗机进行全结肠透析治疗，具体采用结肠清洗一结肠透析一注药三步疗法。结果：通过全结肠透析治疗，治疗组患者治疗后血浆内毒素水平、血氨、氮质血症较治疗前显著下降（P〈0．05），尤其是消化道出血后肝性脑病发生率为零，肝性脑病患者经治疗清醒时间明显缩短。结论：慢性重型肝炎患者通过全结肠透析的干预，可有效减少其严重并发症的发生率，降低病死率。     

Sixty-two Cases of Intractable Ascites due to Cirrhosis Treated by the Modified Wulingsan Power plus Abdominal Reinfusion of the Concentrated Ascites after Ultrafiltration

Objective： To observe the clinical therapeutic effects of Wulingsan Jiawei （五苓散加味 Supplemented Powder of Five Drugs with Poria, SPFDP） plus abdominal reinfusion of concentrated ascites after ultrafiltration （ARCAU） for intractable ascites due to cirrhosis （IAC）. Methods： 124 cases of IAC were randomly divided into two groups, a treatment group of 62 cases treated by oral administration of SPFDP plus ARCAU and a control group of 62 cases treated simply by ARCAU. Aldosterone （ALD） level in plasma, levels of total bilirubin （TBIL） and albumin （ALB） in serum, and activity of alanine aminotransferase （ALT） were determined in the two groups before and after treatment. Results： After treatment ALT activity and TBIL level in the treatment group were significantly lower than those in the control group, and ALB content in the treatment group was significantly higher than that in the control group. ALD level of the treatment group significantly decreased after treatment as compared with that before treatment, while that of the control group did not decreased significantly after treatment. The treatment group was significantly superior in keeping down ascites to the control group. Conclusion： SPFDP plus ARCAU treatment oflAC can markedly raise the clinical therapeutic effect, reduce recurrence of ascites, and improve the liver function, which can produce a significant decrease in ALD level in plasma and a marked increase in ALB content.     

软肝利水丸治疗肝硬化顽固性腹水42例临床观察

肝硬化腹水是肝硬化失代偿期最突出的临床表现,其中约有10%~20%形成顽固性腹水,腹水的长期大量潴留极易诱发各种严重并发症,使病情恶化,严重影响患者的生存质量,并对患者生命构成极大威胁。作者采用软肝利水丸疗法治疗肝硬化顽固性腹水取得了较好的疗效,同时也初步探讨了本疗法     

结肠净化对肝性脑病干预的临床研究

目的 观察结肠净化治疗肝性脑病的临床疗效.方法 将我院收治的肝硬化合并肝性脑病患者117例随机分为两组,治疗组59例,对照组58例,在积极去除诱因基础上,两组患者均给予常规的抗肝性脑病治疗,治疗组在上述治疗的基础上加用结肠净化治疗.比较两组患者治疗前后症状、体征、肝功能、血氨及治疗后恢复清醒时间的变化,总有效率及死亡率.观察治疗前后的肝性脑病分期计分情况.结果 治疗组与对照组比较,治疗组可明显改善患者的症状体征,缩短患者的清醒时间,降低患者的血清转氨酶、胆红素及血氨水平,提高总有效率,降低死亡率,改善肝性脑病的计分值.结论 结肠净化是较为有效的治疗肝硬化合并肝性脑病的疗法.     

结肠透析对慢性重型肝炎严重并发症的干预研究

目的:对重型肝炎血浆置换前后可溶性Fas与FasL水平变化进行临床应用的研究。方法:对135例2000年11月至2005年1月住院的病毒性肝炎乙型重型患者进行基础治疗,血浆置换等方面的治疗并通过标本采集与统计学方法进行相关分析。结果:PE术前重型肝炎患者的血清SFas、SFasL和SFas/SFasL与正常对照组比较均显著升高,随PE治疗次数增多,A组的血清FasL、SFasL水平显著性下降,而B组血清FasL、SFasL水平有不同程度升高。结论:适当增加血浆置换量、延长PE治疗时间,如持续缓慢地进行PE治疗,或缩短治疗间歇期,能下调血清SFas、SFasL水平,保持SFas/SFasL合理比值,可有效提高重肝PE治愈率。