结肠灌洗联合血浆置换序贯治疗慢性重型肝炎内毒素血症的临床研究

目的：探讨结肠灌洗联合血浆置换序贯治疗慢性重型肝炎内毒素血症的临床疗效。方法：将246例重型肝炎患者随机分为3组：联合治疗组（86例）采用结肠灌洗联合血浆置换序贯治疗配合传统内科药物治疗，血浆置换纽（80例）采用血浆置换序贯治疗配合传统内科药物治疗，对照组（80例）采用传统内科药物治疗。检测3组患者治疗前后血清内毒素、肝功能、血氨等生化指标，观察患者临床症状和体征的改善情况及其预后。结果：联合治疗组内毒素、血氨下降的幅度，肝功能、症状的改善及生存率的提高均明显好于血浆置换组及对照组。结论：结肠灌洗联合血浆置换序贯疗法能有效地降低重型肝炎患者的内毒素血症，改善肝功能，缓解临床症状，提高存活率。

Clinical study of the coloclyster combined with plasma exchange in patients of severe chronic hepatitis

To investigate the clinical effectiveness of the coloclyster combined with plasma exchange in patients with severe chronic hepatitis. Methods： Two hundred and fonty-six patients with severe chronic hepatitis were divided into three groups： combined group with 86 patients, received coloclyster and plasma exchange, also traditional medical treatment; the plasma exchange group with 80 patients, received plasma exchange and traditional medical treatment; the controlled group with 80 patients just received the traditional medical treatment. To compare serum endotoxin, liver function, blood ammonia, and other biochemical markers of the three groups before and after treatment, observe the improvement in patients with clinical symptoms and signs, and its prognosis. Results： The declined range of serum endotoxin, blood ammonia, improvement of clinical symptoms, increasing of survival rate in combined group were better than that of the plasma exchange group and the controlled group. Conclusion： The coloclyster combined with plasma exchange can effectively decrease the endotoxemia, ameliorate the liver function, improve the clinical symptoms, increase the survival rate for patients with severe chronic hepatitis.