【作者】 李智； 李长春； 严红梅； 徐欢； 梁群；

【Author】 LI Zhi LI Chang-chun YAN Hong-mei XU Huan LIANG Qun The liver disease faculty of the seventh hospital of wuhan 430021,China

【机构】 武汉市第七医院肝病科；

【摘要】 目的:分析人工肝支持系统(ALSS)血浆置换(PE)治疗重型肝炎的临床疗效及影响因素。方法:对72例重型肝炎在内科基础综合治疗同时采用日本产 PLASAUT-IQ 型人工肝机进行血浆置换治疗。结果:重型肝炎 PE 治疗共155人次,平均2次,PE 治疗后5天黄疸无快速回升到原来水平的17例均存活。亚重肝早期患者存活为85.71%,慢重肝早期患者存活为75.86%,PE 对亚重肝早期疗效优于慢重肝早期(P>0.05),慢重肝早期、中期和慢重肝晚期存活率有显著性差异(P>0.05)。CHE、PTA 低,疗效差。结论:ALSS 血浆置换治疗重型肝炎能改善症状,提高存活率,对早期重型肝炎疗效好。TBil、CHE、PT、感染等可作为 PE 治疗效果的预测指标。更多还原

【Abstract】 Objective To determine the clinical effects and influenced factors of plasma exchange(PE)of artificial liver support system(ALSS)in the treatment of liver failure.Methods 72 cases of severe hepatitis were treated with plasma exchange combined with medical integrated treatment:Results 155 person-time were treated with PE,the average times of every cases are two times.17cases survive whose jaundice didn’t go up the former lever after five days passing through the treatment of PE.The livability of patients on forepart of subacute severe hepatitis is 85.71%,the livability of patients on forepart of chronic gravis hepatitis is 75.86%,the curative effect of forepart of subacute severe hepatitis is excel to forepart of chronic gravis hepatitis(P>0.05).The livability among forepart,metaphasen and afternoon of chronic gravis hepatitis is distinct difference.The curative effect of patient whose lever of CHE and PTA is low is bad.Conclusion Plasma exchange of artificial liver support system can significantly improve the clinical symptoms,blood parameters and mortality,the effect of forepart severe hepatitis is much more better.TBil、CHE、PT and infection are forecasted indexes of curative effect of plasma exchange in the treatment of severe hepatitis.更多还原