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目的 :观察人工肝支持系统 (ALSS)血浆置换 (PE)术治疗重型病毒性肝炎的临床疗效及安全性。方法 :对30例重型肝炎患者应用PE治疗45例次 ,通过比较治疗前后患者临床症状、肝功能、凝血酶原活动度等指标判断临床疗效、观察与治疗相关的不良反应及患者耐受情况判断其安全性和可行性。结果 :血浆置换术后重型肝炎患者自觉症状明显改善达87 % ,血清胆红素平均降低34 3 % ,PTA上升13 %。治疗过程中以血压下降、心慌、恶心、过敏等不良反应发生率20 % ,未发生大出血、休克等严重并发症和血制品引起的重叠感染 ,耐受情况良好。结论 :PE可显著改善肝功能衰竭患者临床症状及生化指标 ,提高近期存活率 ,且安全可行。
Objective: To observe the clinical efficacy and safety of artificial liver support system (ALSS) plasma exchange (PE) in the treatment of severe viral hepatitis. Methods: Forty-five patients with severe hepatitis were treated with PE for 45 times. The clinical efficacy, clinical symptoms, hepatic function and prothrombin activity were compared before and after treatment to observe the adverse reactions and the judgment of patients’ tolerance Its safety and feasibility. Results: The symptoms of patients with severe hepatitis after primary plasma replacement significantly improved by 87%, serum bilirubin averaged 34 3% and PTA increased 13%. In the course of treatment, the incidence of adverse reactions such as decreased blood pressure, palpitation, nausea, and allergy was 20%. No serious complications such as hemorrhage, shock, or overlapping infections caused by blood products occurred. The patients were well tolerated. Conclusion: PE can significantly improve the clinical symptoms and biochemical indexes in patients with liver failure, improve the survival rate in recent years, and is safe and feasible.