血浆置换治疗重症肝炎时电解质变化的临床研究

目的：观察血浆置换治疗重症肝炎时电解质的变化情况及对疗效的影响。方法：随机选取58例重症肝炎患者，其中并发低钾血症24例，低钠血症31例，低氯血症33例，在内科治疗的基础上加用血浆置换治疗，观察治疗前后血清K^＋、Na^＋、Cl^-、HCO3^-、Ca^2＋及肝功的变化情况，并对治疗前后血清电解质水平进行比较。结果：血浆置换治疗前后血清中K^＋、Na^＋、Cl^＋水平存在明显差异，HCO3^-、Ca^2＋变化不明显。存活患者治疗前后电解质水平差异明显，无效患者则无明显改善。结论：血浆置换治疗重症肝炎可有效纠正电解质紊乱，纠正的程度可能影响患者的预后。

Changes of serum electrolyte in treatment of liver failure with plasma exchange

Objective:To observe the changes of serum electrolyte in the treatment of liver failure with plasma exchange and its influence on the curative effect. Methods: Fifty-eight patients with liver failure were selected randomly. Among them, 24 were complicated by hypokalemia, 31 by hyponatremia and 33 by hypochloraemia. All the patients underwent plasma exchange combined with routine treatment. The changes of their serum electrolyte levels, including K +, Na +, Cl -, HCO_3 - and Ca 2+ and their liver function before and after treatment were observed. Results:There was significant difference between the levels of K +, Na +, Cl - before and after treatment, while no significant change occurred in the levels of HCO_3 - and Ca 2+. In addition, the difference of serum electrolyte levels before and after treatment in the survival patients was significant, while there was no obvious change in the other patients. Conclusion: The treatment of plasma exchange can effectively rectify the disturbance of electrolyte in patients with liver failure, and the rectified effect on their serum electrolyte levels may affect the prognosis of the patients.