人工肝血浆置换治疗慢性重型肝炎疗效观察与护理

目的观察人工肝血浆置换治疗慢性重型肝炎的临床疗效及总结护理体会。方法92例慢性重型肝炎患者随机分为对照组(n=52)及治疗组(n=40)。对照组给予常规内科治疗,在此基础上对治疗组进行血浆置换治疗。观察治疗前后患者临床症状的变化,测定血液肝肾功、凝血酶原活动度及电解质变化。对比两组存活率。总结护理注意要点。结果经治疗后患者临床症状显著改善(P<0.05);患者胆红素明显降低(P<0.05);白蛋白、胆碱酯酶、凝血酶原活动度明显增加(P<0.05);电解质紊乱明显改善(P<0.05);而对肾功影响不明显。未出现严重并发症。治疗组存活率明显高于对照组(P<0.05);其中早、中期患者存活率高于对照组(P<0.05),而晚期存活率比较无显著性差异。结论在常规内科治疗基础上加用人工肝血浆置换是治疗慢性重型肝炎的一种安全有效的肝脏替代治疗方法,且在病程早期进行效果较好。

The Curative Effects of Artificial Liver Plasma Exchange on Patients with Chronic Liver Failure and Its Nursing

Objective:To investigate the curative effects of artificial liver plasma exchange (PE) on patients with chronic liver failure.Methods:92 patients with chronic liver failure were randomly divided into the control group(n=52) and the treatment group(n=40). The control group was treated with general medcine. Besides the general medcine, the treatment group was treated with PE. The changes of clinical symptoms, liver and kidney functions, prothrombin time and serum electrolyte level before and after treatment were observed, andthe survival rates of two groups were compared and the experiences of nursing were summarized.Results:After treatment with PE, the clinical symptoms were improved (P<0.05). The total bilirubin and direct bilirubin were significantly decreased (P<0.05). The albumin, cholinesterase and prothrombin time were significantly increased (P<0.05). The turbulence of serum electrolyte level was corrected (P<0.05) and kidney function was insignificantly changed.The survival rate of treatment group was significantly higher than that of the control group (P<0.05). But there was no significant difference between two groups in the terminal stage.Conclusion:Combined PE treatment and general medicine was a safe and efficient therapy to treat the patients with chronic liver failure in the early and middle stage.