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目的 分析 2 6例急性重型肝炎 (ASH)和 2 1例亚急性重型肝炎 (SSH)的病理和临床特点。方法 对我院近 2 0年经尸检或肝穿刺病理证实死亡的ASH和SSH患者的临床特点进行分析。结果 ①ASH和SSH昏迷发生的时间 ,发病 10d内昏迷者ASH为 80 .1% ,发病 14d内昏迷者ASH为 92 .0 % ;②发病年龄分别为 (35± 11)岁和 (5 3± 11)岁 ,P <0 .0 0 1;③脑水肿的发生率分别为 10 0 %和 6 1.9% ,P <0 .0 1;④较大量腹水的发生率分别为35 .3%和 10 0 .0 % ;⑤胆固醇均降低 ,且降低的数值及PTA变化与疾病发生、发展密切相关 ;⑥ 2例急性黄疸型肝炎患者在疾病恢复期转型为急性重型肝炎。结论 ①急性重型肝炎约有 1/ 3患者可出现较大量腹水 ;②PTA、CHO与疾病变化密切相关 ;③急性肝炎治疗期间可以因为某些特殊诱因而出现转型 ,转型后的临床和病理与急性重型肝炎相同 ,也应该按照急性重型肝炎予以认识和处理
Objective To analyze the pathological and clinical features of 26 cases of acute severe hepatitis (ASH) and 21 cases of subacute severe hepatitis (SSH). Methods The clinical features of ASH and SSH patients who died of autopsy or liver biopsy in our hospital in the recent 20 years were analyzed. Results ① The onset time of SH and ST coma was 80.1% in 10 days after onset and 92.0% in 14 days after onset. The age of onset was 35 ± 11 and 35 ± 11 respectively ) Years old, P <0.01; ③ The incidence of cerebral edema was 100% and 6 1.9% respectively, P <0.01; ④ The incidence of the larger amount of ascites was 35.3% and 100 .0%; ⑤Cholesterol decreased, and the decrease of the value and PTA changes were closely related to the occurrence and development of the disease; ⑥two cases of acute jaundice hepatitis in patients with acute jaundice hepatitis transition to acute severe hepatitis. Conclusions ①About one third of patients with acute severe hepatitis may have a large amount of ascites; ②PTA and CHO are closely related to the changes of the disease; ③Acute hepatitis can be transformed due to some special inducement during the course of acute hepatitis; the clinical and pathological and acute heavy The same hepatitis, it should be in accordance with acute severe hepatitis to be recognized and dealt with