【摘要】 目的研究血浆置换(PE)联合持续性血液透析滤过(CHDF)治疗重型肝炎的效果。方法将2011年2月至2014年5月梅州市人民医院感染科收治的120例重型肝炎患者按照随机数字表法分为三组:A组(38例)采用PE+综合内科治疗,B组(42例)采用PE+CHDF+综合内科治疗,C组(40例)采用综合内科治疗。比较各组的临床疗效、生化指标变化及近期生存率情况。结果 B组总有效率为95.2%,明显高于A组(68.4%)和C组(52.5%)(P<0.01)。治疗后三组患者肝肾功能等生化指标均较治疗前改善,且B组改善程度最大(P<0.01),而A组改善程度较C组明显(P<0.01)。B组症状改善率为100.0%,明显高于A组(73.7%)和C组(45.0%)(P<0.01)。B组患者生存率为78.6%,明显高于A组(47.6%)和C组(35.0%)(P<0.01)。结论 PE联合CHDF治疗重型肝炎,疗效确切,可有效改善临床症状和肝肾功能,提高近期生存率,改善患者预后。更多还原

【Abstract】 Objective To study the effect of plasmapheresis( PE) and continuous hemodialysis filtration( CHDF) for the treatment of severe hepatitis. Methods A total of 120 patients with severe hepatitis admitted to the Guangdong Meizhou People’s Hospital from Feb. 2011 to May 2014 were divided into group A,B,C according to random-number table method. Group A: 38 cases,using PE + comprehensive medical treatment; group B: 42 cases,using PE + CHDF + comprehensive medical treatment; group C: 40 cases,with comprehensive medical treatment. The clinical efficacy,changes of biochemical indicators and short-term survival rate of the three groups were observed. Results After treatment,the effect of group B( 95. 2%) was highest and significantly higher than that in group A( 68. 4%) and group C( 52. 5%)( P < 0. 01). The liver and kidney functions of the three groups such as biochemical index was improved from before treatment,and group B had the most significant improvement( P < 0. 01),group A was better than group C( P < 0. 01). The symptoms improvement of group B( 100. 0%) was obviously higher than that of group A( 73. 7%) and group C( 45. 0%)( P < 0. 01). Group B’s survival rate( 78. 6%) was obviously higher than that of group A( 47. 6%) and group C( 35. 0%)( P < 0. 01). Conclusion PE combined with CHDF treating severe hepatitis has a good curative effect,and can effectively improve the clinical symptoms,the function of liver and kidney,the recent survival rate and the prognosis.更多还原