血浆置换联合血浆灌流治疗慢性肝炎重度黄疸临床观察

宋树芬; 王宝华; 陈美珠

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中国血液净化 ›› 2006, Vol. 5 ›› Issue (1) : 38-40.

人工肝

血浆置换联合血浆灌流治疗慢性肝炎重度黄疸临床观察

宋树芬王宝华陈美珠

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摘要

目的探讨血浆置换+血浆灌流(PE+PP)治疗慢性肝炎重度黄疸的疗效及临床价值。方法对青岛市传染病医院血液净化中心72例慢性肝炎重度黄疸患者随机分为治疗组和对照组，对照组35例患者只给予综合治疗，治疗组37例患者在综合治疗的基础上给予(PE+PP)治疗，并分别观察2组治疗前后症状、体征、肝功能、PTA、血常规、电解质及(PE+PP)治疗中并发症的发生；检测治疗后2周、4周的肝功能、PTA等并追踪近期转归。结果治疗组经(PE+PP)治疗后肝功能改善明显，PTA明显上升。治疗后 2周、4周较治疗前，治疗组TBil下降明显(P＜0.01)，PTA上升明显(P＜0.05)。治疗组治愈好转率89.2%，对照组治愈好转率71.4%，疗效比较差异明显(P＜0.01)。结论 (PE+PP)治疗慢性肝炎重度黄疸患者能显著改善肝功能，阻止病情恶化，明显提高临床治愈好转率。

Abstract

Objective To study the therapeutic effect of plasma exchange and plasma perfusion（PE+PP）on chronic hepatitis patients with severe jaundice. Methods Seventy-two patients with severe jaundice were divided into two groups randomly. In the treating group, the patients were treated with (PE+PP) on the basis of the conventional therapy, but the control group received the conventional therapy only. The main symptoms, liver function, prothrombin activity(PTA) before and 2 weeks, 4 weeks after treatment, were observed. Results After treating with (PE+PA), the liver function were ameliorated. The prothrombin activity increased significantly. 2 weeks, 4 weeks after treatment, the level of total bilirubin decreased markedly（P＜0.01),the prothrombin activity increased significantly(P＜0.05).The total effective rate in the treating group was 89.2%, while 71.4% in the control group. There were significant differences between the two groups（P ＜0.01). Conclusion Artificial liver support system can ameliorate the liver function of chronic with hepatitis patients severe jaundice. It can also increase the survival rate.