中国血液净化

›› 2002, Vol. 1 ›› Issue (8): 27-29.

• 论著 • 上一篇    下一篇

血液滤过透析联合血浆置换治疗中晚期慢性重型肝炎的临床研究

庄 鹏 江元森 李学俊 谢俊强 邓 友 张绍全 姚集鲁   

  1. 510630 广州，中山大学第三医院人工肝研究室
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2002-08-19 发布日期:2002-08-19

  • Received:1900-01-01 Revised:1900-01-01 Online:2002-08-19 Published:2002-08-19

RichHTML

0

PDF

282

摘要： 【摘要】目的 探讨人工肝辅助装置持续缓慢血液透析滤过(HDF)联合血浆置换（PE）治疗中晚期慢性重型肝炎的临床疗效及作用机制。 方法 本研究所有患者均为慢性重型肝炎患者，其中治疗组42例，中期18例，晚期24例；对照组33例，中期14例，晚期19例。2组病例均合并有不同程度的并发症。在相同内科治疗的基础上，治疗组加用日产KM-8800血浆交换仪并联用JUN-500血液透析滤过仪进行人工肝治疗，观察治疗的情况。结果 治疗组的42例患者中20例治愈或好转，另有6例经治疗后维持到接受肝移植手术，有效率61.9%；对照组33例中 6例治愈或好转，另有1例接受肝移植手术，有效率21.2%明显低于治疗组 P<0.0。结果显示HDF联合PE治疗有效改善了中晚期慢性重型肝炎患者的预后。在58次治疗过程中发生不良反应10次（17.2%），经对症处理后不良反应均能缓解。结论 在内科综合治疗的基础上CHDF联合PE治疗对中晚期慢性重型肝炎安全有效，能有效提高慢性重型肝炎患者的存活率。

关键词: 血液透析滤过, 血浆置换, 重型肝炎

Abstract: 【Abstract】Objective To study the clinical effect and its mechanism of artificial liver support system(ALSS) about continuous hemodiafiltration(CHDF) plus plasma exchange(PE) in treatment of patients with chronic severe hepatitis at intermediate or late stage. Methods All the patients were suftering from chronic severe hepatitis in this study. 42 cases served as treatment group and 33 cases served as control group. In the treatment group, 18 cases were at the intermediate stage and 24 cases were at late stage. In the control group, the cases at the intermediate and late stages were respectively 14,19. All patients were had some complications . On the base of treatment of medicine, an additional artificial liver support system of KM-880 plasma exchange device made in Japan together with JUN-500 hemodiafiltration device was used in treatment group. The effect was observed and investigated. Results Of 42 patients in the treatment group, 20 cases were cured or improved after treatment and 6 cases were maintained by artificial liver system till an operation of liver transplantation was received. The total survival rate was 61.9%. However， in the control group, 6 cases survived and 1 case was performed with liver transplantation, The total survival rate was 21.2%. These results showed that treating with CHDF plus PE can effectively improve the prognosis of the patients with chronic severe hepatitis at the intermediate and late stages. During the process of treatment, 10 times of side effects were found(17.2%),but they were relieved after expectant treatment. Conclusion On the base of treatment of medicine ，CHDF plus PE have been proved safe and effective in treating the patients with chronic severe hepatitis at intermediate and late stage, and they can improve the survival rate of the patients.

Key words: Plasma exchange, Severe hepatitis