论文部分内容阅读
目的回顾分析两种人工肝即血浆置换与血浆灌流在重型病毒性肝炎治疗中的应用效果及安全性。方法对151例重型肝炎患者随机分为3组,血浆置换组、血浆灌流组和基础治疗组。前两组在基础治疗组基础上分别给予血浆置换治疗或血浆灌流治疗。观察比较3组治疗前后患者临床症状、体征、肝功能、凝血功能、血常规等指标的变化。结果3组治疗后患者临床症状均有不同程度缓解,血浆置换组、血浆灌流组及基础治疗组的有效率分别为78.57%、43.59%和19.04%,2组人工肝与基础治疗组比较差异显著(p<0.05),血浆置换组与血浆灌流组差异也有明显差异(P<0.05)。血浆置换组治疗后总蛋白,白蛋白明显上升,PTA升高,总胆红素下降明显,与基础治疗组比较差异显著(P<0.05)。血浆灌流组胆红素明显下降,与基础治疗组差异显著(p<0.05),而总蛋白、白蛋白、PTA、白细胞与基础治疗组显著性差异(p>0.05)。不良反应为发热和皮疹,经对症治疗后均恢复。结论血浆置换和血浆灌流均能提高重型肝炎患者的生存率,血浆置换较血浆灌流更显著改善重型肝炎患者的生存率及生化指标,有助于提高重型肝炎治疗的有效率。
Objective To retrospectively analyze the effects and safety of two kinds of artificial liver, plasma exchange and plasma perfusion in the treatment of severe viral hepatitis. Methods 151 cases of severe hepatitis were randomly divided into three groups, plasma exchange group, plasma perfusion group and basic treatment group. The first two groups were treated with plasma exchange or plasma perfusion based on the basic treatment group. The changes of clinical symptoms, signs, liver function, coagulation function and blood routine in 3 groups before and after treatment were observed and compared. Results The clinical symptoms of the three groups were relieved to varying degrees. The effective rates of the plasma exchange group, the plasma perfusion group and the basic treatment group were 78.57%, 43.59% and 19.04% respectively. There were significant differences between the two groups (p <0.05). There was also significant difference between plasma exchange group and plasma perfusion group (P <0.05). After treatment, the total protein and albumin in plasma exchange group increased significantly, PTA increased, and total bilirubin decreased significantly (P <0.05). The level of bilirubin in plasma-perfusion group was significantly lower than that in the basal group (p <0.05), while the levels of total protein, albumin, PTA and leukocyte were significantly different from those in the basal group (p> 0.05). Adverse reactions to fever and rash recovered after symptomatic treatment. Conclusion Both plasma exchange and plasma perfusion can improve the survival rate of patients with severe hepatitis. Plasma exchange can significantly improve the survival rate and biochemical indexes of patients with severe hepatitis compared with plasma perfusion, which is helpful to improve the efficiency of treatment of severe hepatitis.