血浆置换治疗慢性重型肝炎临床疗效观察

目的　观察人工肝支持系统血浆置换对慢性重型肝炎的疗效。方法　对 32例慢性重型肝炎患者给予血浆置换 59次。观察患者临床症状、肝肾功能、电解质、凝血酶原活动度(PTa)、血氨、血常规变化。结果　血浆置换后,患者临床症状均得到不同程度的改善。血浆总胆红素、直接胆红素、丙氨酸转氨酶、天门冬氨酸转氨酶、血氨较治疗前明显降低 (P<0 01或P<0 05 ),PTa上升 (P<0 05)。不良反应较轻。早期重症肝炎 7例全部存活(100% ),中期重症肝炎 15例中存活 10例(66 7% ),晚期重症肝炎 10例存活 3例(30% )。结论　血浆置换对早、中期慢性重症肝炎疗效较好。

Effects Observation of Plasma Exchange in Treatment of Chronic Severe Hepatitis

Objective To investigate the therapeutic effect of artificial liver support system (plasma exchange) in chronic severe hepatitis.Methods 32 patients with chronic severe hepatitis were treated with 59 case-times of plasma exchange.The result of liver function,renal function,electrolyte,prothrombin time activity (PTa),blood ammonia,blood routine before and after the treatment were analyzed.Results After plasma exchange,symptoms of patients with chronic severe hepatitis were improved.Alanine tranasaminase and aspartase tranasaminase,total bilirubin,direct bilirubin,blood ammonia obviously decreased (P<0.05 or P<0.01),PTa obviously increased (P<0.05).The side effects were mild.The survival rate in early,medium-term,late chronic severe hepatitis were 100%(7/7),66.7%(10/15),30%(3/10) repectively.Conclusion Plasma exchange is comparatively effective in the treatment of early,medium-term chronic severe hepatitis.