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目的探讨终末期肝病评分差值(ΔMELD)及MELD联合血清钠差值(ΔMELD-Na)在血浆置换前后的变化及对判断患者预后的意义。方法选择肝衰竭患者228例,根据患者3个月内的病情转归,病情好转出院140例(生存组),病情恶化死亡或濒临死亡自动出院88例(死亡组)。回顾性分析患者的临床资料,比较两组ΔMELD、ΔMELD-Na的分值。结果生存组ΔMELD高于死亡组[(8.36±6.99)分vs.(5.28±3.49)分](P<0.01),生存组ΔMELD-Na高于死亡组[(5.12±4.65)分vs.(2.41±1.77)分](P<0.01)。结论ΔMELD、ΔMELD-Na对肝衰竭患者行血浆置换的疗效及预后判断有指导意义。
Objective To investigate the changes of end-stage liver disease score (ΔMELD) and MELD combined with serum sodium difference (ΔMELD-Na) before and after plasma exchange and its significance in judging the prognosis of patients. Methods A total of 228 patients with hepatic failure were selected. According to the patient’s prognosis within 3 months, 140 cases (survival group) were discharged and discharged. 88 patients (death group) were discharged from the hospital after exacerbation or death. The clinical data of patients were retrospectively analyzed. The scores of ΔMELD and ΔMELD-Na were compared between the two groups. Results The level of ΔMELD in survival group was higher than that in death group [(8.36 ± 6.99) vs 5.28 ± 3.49 (P <0.01) ± 1.77) points (P <0.01). Conclusion △ MELD, △ MELD-Na in patients with liver failure plasma exchange efficiency and prognostic significance.