重型病毒性肝炎并发症与预后的关系

目的探讨重型病毒性肝炎患者并发症的出现与其预后的关系.方法分析573例重型病毒性肝炎患者各种并发症的发生率,比较出现不同类型并发症的重型病毒性肝炎患者的存活率.结果 77.8%重型病毒性肝炎患者存在并发症,其中肝性脑病、感染、脑水肿、消化道出血、肝肾综合征的发生率分别为50.4%、34.6%、30.2%、22.2%和21.8%;无并发症的重型病毒性肝炎患者存活率为78.7%,非常显著高于有并发症者(13.7%),P<0.01;重型病毒性肝炎患者并发症越多,其存活率也越低;125例出现肝肾综合征的患者全部死亡,单纯肝性脑病、单纯感染和单纯消化道出血者的存活率分别为63.9%、68.4%和46.2%.结论绝大多数重型病毒性肝炎患者存在并发症,并发症的出现是重型病毒性肝炎患者病情加重、预后差的重要标志.

Relationship between prognosis and complications of patients with severe viral hepatitis

Objective To investigate the relation between the prognosis and complication of patients with severe viral hepatitis (SVH) Methods The incidences of different complications in 573 patients with SVH were analyzed The survival rates of SVH patients with different complications were compared Results Complications were diagnosed in 77 8% SVH patients The incidences of hepatic encephalopathy, infection, brain edema, gastrointestinal hemorrhage, and hepatorenal syndrome were 50 4%, 34 6%, 30 2%, 22 2%, and 21 8%, respectively The survival rate of SVH patients without complications was 78 7%, significantly higher than that of patients with complications (13 7%, P <0 01) More complications in SVH patients resulted in lower survival rates None survived in 125 patients with hepatorenal syndrome The survival rates of SVH patients with simple hepatic encephalopathy, simple infection, and simple gastrointestinal hemorrhage were 63 9%, 68 4%, and 46 2%, respectively Conclusion Complications may be present in most SVH patients The occurrence of complications may be the key marker of the worse condition and poor prognosis of SVH patients