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目的:通过对248例早中期慢性乙型重型肝炎进行血浆置换联合抗病毒治疗的临床分析,探讨早中期慢性乙型肝炎的有效治疗方案及不同核苷类抗病毒药物选择对预后的影响。方法:所有病例均采用人工肝血浆置换联合抗病毒治疗。结果:248例慢性乙型重型肝炎患者总有效率69.3%,无效率30.7%;治疗前后自身对比,血清总胆红素、谷丙转氨酶、谷草转氨酶、胆碱酯酶、血清白蛋白、凝血酶原活动度等指标均有明显改善,P<0.05。抗病毒药物中恩替卡韦及拉米夫定组有效率较高。结论:慢性乙型重型肝炎早中期患者,血浆置换联合抗病毒治疗可以取得良好的治疗效果,抗病毒药物选择恩替卡韦或者拉米夫定可能会提高有效率。
OBJECTIVE: To explore the effective treatment of early-to-middle chronic hepatitis B and the effect of different nucleoside antiviral drugs on the prognosis of 248 patients with early-to-middle-stage chronic severe hepatitis B by plasma exchange combined with antiviral therapy. Methods: All cases were treated with artificial liver plasma exchange combined with antiviral therapy. Results: The total effective rate was 69.3% and the inefficiency rate was 30.7% in 248 patients with chronic severe hepatitis B. Compared with before treatment, serum total bilirubin, alanine aminotransferase, aspartate aminotransferase, cholinesterase, serum albumin, thrombin Original activity and other indicators were significantly improved, P <0.05. Antiviral drugs entecavir and lamivudine group more efficient. Conclusion: Early and mid-term patients with chronic severe hepatitis B, plasma replacement combined with antiviral therapy can achieve good therapeutic effect, the choice of antiviral drugs entecavir or lamivudine may improve the efficiency.