目的探讨血浆置换联合连续性血液滤过治疗重型乙型病毒性肝炎的临床疗效。方法对22例用血浆置换联合连续性血液滤过技术治疗的患者(治疗组)与18例开展连续性血液滤过技术前单用血浆置换治疗的患者(对照组)进行治疗效果的回顾性对比分析。结果两组治疗后肝功能均较治疗前显著好转(P<0.01)。治疗组治疗后血氨显著降低(P<0.01),肝性脑病患者意识转清率为76.92%。连续性血液滤过治疗期间可见患者球结膜水肿明显减轻,持续性中枢性高热得到控制。治疗组患者的病情虽较对照组重,但治疗组治愈好转率为45.45%,与对照组相似。结论血浆置换联合连续性血液滤过治疗重型乙型病毒性肝炎较单纯血浆置换治疗的适应证范围扩大并取得较好效果,为重型乙型病毒性肝炎患者带来了更多的生存机会。 Objective To investigate the clinical efficacy of plasma exchange combined with continuous hemofiltration in the treatment of severe hepatitis B virus infection. Methods A retrospective comparison of the efficacy of treatment in 22 patients treated with plasma exchange and continuous hemofiltration (treatment group) and 18 patients treated with single plasma exchange before continuous hemofiltration (control group) was performed analysis. Results After treatment, the liver function of both groups improved significantly (P <0.01). After treatment, the blood ammonia in treatment group was significantly lower (P <0.01), and the rate of consciousness-seeking in patients with hepatic encephalopathy was 76.92%. Continuous hemofiltration during the treatment of patients with significant reduction of conjunctival edema, persistent central fever was controlled. The treatment group patients than the control group, although the disease weight, but the cure rate of cure was 45.45%, similar to the control group. Conclusion Plasma exchange combined with continuous hemofiltration treatment of patients with severe hepatitis B than plasma replacement therapy to expand the scope of indications and achieved good results for patients with severe hepatitis B has brought more opportunities for survival.