不同类型非生物型人工肝治疗重型肝炎的总体疗效评估

目的评估目前临床开展的不同类型非生物型人工肝治疗重型肝炎患者的总体疗效。方法回顾性研究我院住院的重型肝炎患者507例,其中内科综合治疗124例,人工肝治疗组383例,结果不同类型非生物型人工肝治疗重型肝炎患者治疗结束时肝脏功能均有不同程度的改善（P〈0.05）,治疗后72h凝血酶原活动度（PTA）均较治疗前明显好转（P〈0.05）,治疗后72h黄疸（TB）均存在不同程度反弹（P〈0.05）。不同术式人工肝对不同类型重型肝炎的治疗,慢性重型肝炎存活率远低于急性及亚急性重型肝炎（P〈0.05）。对亚急性及慢性重型肝炎早、中、晚期的远期疗效,早期存活率为88.3%,较中期及晚期高（P〈0.05）,晚期疗效最差为37.5%（P〈0.05）。进行人工肝的重型肝炎患者存活率高于未进行人工肝治疗的重型肝炎患者（P〈0.05）。2次及以上人工肝治疗患者存活率高于1次人工肝治疗,但差异无统计学意义（P〉0.05）。结论不同类型非生物型人工肝对重型肝炎生化指标有不同程度的改善,能提高急性重型肝炎及早期患者的存活率。

Overall efficacy assessment of different types of nonbioartificial liver treatment of severe hepatitis

Objective To assess the overall effect of the current different clinical types of non-bioartificial liver treatment of severe hepatitis patients.Methods Retrospective study 507 cases of severe hepatitis patients of our hospital,including comprehensive treatment group 124 cases and artificial liver treatment group 383 cases.Results The liver function in severe hepatitis patients after treating by different types of non-bioartificial liver treatment had varying degrees of improvement（P〈0.05）,Prothrombin activity（PTA）of 72 hours after treatment significantly improved than those before treatment（P〈0.05）.Jaundice（TB）of 72 hours after treatment have varying degrees of bouncing（P〈0.05）.The survival rate of chronic severe hepatitis after treating by different types of artificial liver treatment is far lower than those of the acute and sub-acute severe hepatitis（P〈0.05）.The survival rate of early term in sub-acute and chronic severe hepatitis was 88.3%,higher than those of the mid-term and late term（P〈0.05）.The survival rate of late term was only 37.5% and the efficacy was worst.The survival rate of severe hepatitis patients in artificial liver treatment group was higher than those in comprehensive treatment group（P〈0.05）.The survival rate of severe hepatitis patients treated by 2 or more times of artificial liver was higher than those treated by only one time of artificial liver,but there was no significant statistical difference（P〈0.05）.Conclusion The serum biochemical indicators of severe hepatitis have different degree of improvement in acute severe hepatitis and sub-acute and chronic severe hepatitis patients with early stage treated by different types of non-bioartificial liver.