血浆置换对慢性重型肝炎的疗效分析

目的探讨人工肝血浆置换治疗对慢性重型肝炎的临床疗效。方法选取我院肝病科行人工肝血浆置换治疗的慢性重型肝炎患者67例为研究对象,比较治疗前后患者血常规及肝功能等生化学指标的变化,评价血浆置换的疗效。结果 67例重型肝炎患者经过人工肝血浆置换治疗后,白细胞、肝功能、凝血功能等指标及临床症状均得到不同程度的改善。其中,白细胞、直接胆红素在治疗前后差异有统计学意义(t=2.42、2.51,P<0.05),且ALT、AST、PT以及总胆红素的差异尤为显著(t分别为3.58、2.97、4.23及5.25;P均<0.01)。慢性重型肝炎早、中、晚期治疗有效率(包括治愈和好转)分别为86%、57%、11%;早期、中期与晚期重型肝炎患者PE治疗相比,治疗有效率的差异有统计学意义(χ2=18.53,P<0.01)。结论应用人工肝血浆置换治疗慢性重型肝炎是目前比较成熟的肝脏替代疗法,具有一定疗效,尤其对早、中期的患者疗效更佳。

Analysis of efficacy of plasma exchange in patients with chronic severe hepatitis

Objective To investigate the clinical effect on the treatment of chronic severe hepatitis with artificial liver plasma exchange.Methods A total of 67 patients with severe hepatitis at early, middle and late stages received treatment of Artificial Liver Support System. Pre- and post-therapy liver function, blood routine test, PTA, PT were analyzed, and symptoms of all patients were observed. Results After the treatment of plasma exchange, liver function, PTA, PT and blood routine of patients improved. Among them, white blood cells, direct bilirubin have statistical significance before and after treatment （t=2.42, 2.51,P〈0.05）, particularly ALT, AST, PT, and bilirubin were significantly different （t were 3.58, 2.97, 4.23 and 5.25;P〈0.01）. The effective rates of patients with chronic severe hepatitis at early, middle and late stages were 86%, 57% and 11% respectively;compared to the early, middle and late stage PE patients with severe hepatitis treatment, the difference was statistically significant for efficient （χ^2=18.53,P〈0.01）.Conclusion Application of artificial liver plasma exchange in the treatment of chronic severe hepatitis is a relatively mature liver replacement therapy, has certain curative effect, especially on the early, mid patients with better effect.