组合型非生物型人工肝治疗晚期慢性重型肝炎

目的 探讨组合型非生物型人工肝治疗晚期慢性重型肝炎患者的临床疗效，观察其改善肝性脑病，肝肾综合征和电解质紊乱的作用。方法 103例患者随机分成两组，治疗组63例，对照组40例。两组病例均合并有不同程度的并发症。治疗组在内科综合治疗基础上加用组合型非生物型人工肝治疗，对照组加用单纯血浆置换治疗。观察两组治疗前后临床症状、肝功能指标及并发症的变化，并比较近期疗效及生存率。结果 治疗组肝性脑病意识好转率为72．7％（8／11），电解质紊乱纠正率为89．5％（34／38），6例肝。肾综合征患者中4例。肾功能恢复，近期有效率为52．4％（33／63），生存率为47．6％（30／63）；对照组6例肝性脑病患者经治疗后1例意识好转，电解质紊乱纠正率42．3％（11／26），并发肝肾综合征患者无一例肾功能恢复，近期有效率为32．5％（13／40），生存率为22．5％（9／40），两组比较，差异有统计学意义（x^2=6．56，P〈0．05）。结论 在内科综合治疗基础上联合组合型非生物型人工肝治疗能有效提高晚期慢性重型肝炎患者的生存率。

Combined non-biological artificial liver in treatment of late stage chronic severe hepatitis

Objective To explore the clinical effects of combined non-biological artificial liver in the treatment of late stage chronic severe hepatitis and especially to observe their effects on hepatic encephalopathy, hepatorenal syndrome and disturbance of electrolytes. Methods 103 chronic severe hepatitis patients were treated with the same medical measures, including plasma exchange. Among them, 63 patients were also treated with combinations of non-biological artificial liver (treatment group), and the other 40 patients served as controls (control group). The efficacy of the treatments and survival rates of the two groups were compared. Results In the treatment group, the rate of regaining normal consciousness was 72.7%, the rate of electrolyte disorder being rectified was 89.5%, the rate of restoring renal function was 66.7% and the total survival rate was 47.6%. In comparison, in the control group the rate of regaining normal consciousness was 16.1%, the rate of electrolyte disorder being rectified was 42.3%, none of their renal functions were restored and the total survival rate was 22.5%. The differences between the two groups were significant x2 = 6.56, P < 0.05). Conclusion With other medicical treatment, combined non-biological artificial liver can improve the survival rate of severe hepatitis patients.