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目的观察人工肝治疗重型肝炎的临床疗效及其安全性。方法对37例重型肝炎患者应用血浆置换或/和血液(浆)灌流共进行50次治疗,观察患者在人工肝治疗前后症状、体征、血清胆红素、白蛋白、凝血酶原活动度(PTA)变化和不良反应及术后生存率。结果人工肝支持治疗后症状、体征改善显效率为80.00%。治疗前后总胆红素水平显著下降(P<0.01),PTA上升(P<0.01),白蛋白、血红蛋白无显著变化(P>0.05)。术中及术后总并发症发生率为14.29%,主要为皮肤瘙痒、荨麻疹、畏寒、发热、血压下降。术后好转出院26例(70.27%),自动出院7例(18.92%),死亡4例(10.81%)。结论人工肝治疗重型肝炎安全、有效。
Objective To observe the clinical efficacy and safety of artificial liver in the treatment of severe hepatitis. Methods Thirty-seven patients with severe hepatitis were treated with plasma exchange and / or blood (plasma) perfusion for 50 times. The symptoms and signs, serum bilirubin, albumin, prothrombin activity (PTA) ) Changes and adverse reactions and postoperative survival rate. Results After the artificial liver support treatment, the symptoms and signs were improved and the effective rate was 80.00%. The levels of total bilirubin decreased significantly (P <0.01), PTA increased (P <0.01), and albumin and hemoglobin had no significant changes before and after treatment (P> 0.05). The total incidence of intraoperative and postoperative complications was 14.29%, mainly skin pruritus, urticaria, chills, fever, blood pressure. After the operation, 26 cases (70.27%) were discharged, 7 cases (18.92%) were discharged automatically, and 4 cases (10.81%) died. Conclusion The artificial liver treatment of severe hepatitis is safe and effective.