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机构地区:[1]泸州医学院附院感染病科,四川泸州646000
出 处:《中国现代医学杂志》2005年第13期1992-1994,1997,共4页China Journal of Modern Medicine
摘 要:目的探讨plasauto IQ型血浆置换仪对重型肝炎的临床疗效.方法采用plasauto IQ型血浆置换仪对62例(82例次)重型肝炎患者进行血浆置换治疗,每次置换3000~4 000 mL,比较治疗前后患者的有效率.结果总有效率为80.5%,最终存活率62.9%;治疗前后患者的内毒素、肿瘤坏死因子有显著的下降(P<0.01),症状好转,血清转氨酶、白蛋白、球蛋白、胆红素、胆碱脂酶、凝血酶原活动度有明显的改善(P<0.01).首次治疗时期不同,病死率差异有显著性(早期5.3%、中期20.0%、晚期69.6%;P<0.01);治疗2次者死亡率较1次低(8.3%与39.1%,P<0.01);不良反应轻.结论plasauto IQ型血浆置换仪能明显改善患者的症状与肝功能,降低病死率.及早和恰当的选用,效果更佳.[Objective] To evaluate the efficacy of the severe hepatitis patients treated with plasauto IQ plasma exchange. [Methods] 62 candidates (82 times) were employed in the treatment of Plasma exchange with plasauto IQ (3 000~4 000 mL/times), to evaluate the clinical effect pre and post treat. [Results] The total effect rate reached 80.5%, the survival rate was 62.9 %. Symptoms of patients treated with plasma exchange were improved. The plasma level of endotoxin (LPS) and TNF-a reduced remarkablely (P <0.01). Comparing the levels of aminotransferase, albumin, globulin, total bilirubin, PTA, CHE and plasma endotoxin in sera of patients pre and post treat, there was significant difference (P <0.01). There was significant difference of the clinical death rate treated first with plasauto IQ plasma exchange in different stages and different times. (Early stage 5.3% vs mid-stage 20.0% vs late-stage 69.6%, P <0.01 and 2 times/candidate vs 1 times/candidate: 8.3% vs 39.1%,P <0.01). The side effects were very limited. [Conclusion] Plasauto IQ plasma exchange is effective in treating severe hepatitis and reducing the clinical death rate. And it can improve remarkably symptoms and hepatic function of patients. To treat in the early stage and appropriate times,clinical effect will be better.
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