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目的 观察人工肝支持系统血浆置换对慢性重型肝炎的疗效。方法 对 32例慢性重型肝炎患者给予血浆置换 59次。观察患者临床症状、肝肾功能、电解质、凝血酶原活动度(PTa)、血氨、血常规变化。结果 血浆置换后,患者临床症状均得到不同程度的改善。血浆总胆红素、直接胆红素、丙氨酸转氨酶、天门冬氨酸转氨酶、血氨较治疗前明显降低 (P<0 01或P<0 05 ),PTa上升 (P<0 05)。不良反应较轻。早期重症肝炎 7例全部存活(100% ),中期重症肝炎 15例中存活 10例(66 7% ),晚期重症肝炎 10例存活 3例(30% )。结论 血浆置换对早、中期慢性重症肝炎疗效较好。
Objective To observe the curative effect of artificial liver support system plasma exchange on chronic severe hepatitis. Methods Thirty-two patients with chronic severe hepatitis were given plasma replacement 59 times. Clinical symptoms, liver and kidney function, electrolyte, prothrombin activity (PTa), blood ammonia and blood routine were observed. Results After plasma exchange, the clinical symptoms of patients were improved to varying degrees. Plasma total bilirubin, direct bilirubin, alanine aminotransferase, aspartate aminotransferase and blood ammonia were significantly lower than before treatment (P <0.01 or P <0.05), and PTa increased (P <0.05). Adverse reactions are mild. Seven cases of early severe hepatitis survived (100%), 15 cases of mid-term severe hepatitis survived in 10 cases (66.7%) and 10 cases of advanced severe hepatitis survived in 3 cases (30%). Conclusion Plasma exchange is effective in early and intermediate chronic severe hepatitis.