人工肝血浆置换治疗病毒性肝炎高胆红素血症的效价比研究  

Research of effect and price relation in virus hepatitis with hyperbilirubinemia treatet by Artificial Liver Support System(ALSS)

作　　者：张伟军[1] 王建放[1] 苏彩云[1] 

机构地区：[1]福建省厦门市第三医院传染科,福建厦门361100

出　　处：《医学信息（西安上半月）》2005年第8期959-960,共2页Medical Information

摘　　要：目的对人工肝血浆置换治疗病毒性肝炎高胆红素血症进行疗效与价格的研究,旨在进一步了解人工肝血浆置换治疗病毒性肝炎高胆红素血症的价值。方法以入院时患者病情为准,每例患者TBiL>10倍正常值上限,且有明显乏力及消化道症状,但PTA>40%。共46例分为治疗组及对照组,两组患者均给予内科综合治疗,治疗组加用人工肝血浆置换治疗。观察患者病情演变情况,两组的治愈好转率。治疗2周后TBiL及PT改变情况。患者治疗致病情稳定的平均住院日及平均费用。结果人工肝血浆置换治疗在控制病情,避免进展为重型肝炎,减少并发症等方面明显优于对照组。治疗组治愈好转率显著高于对照组(P<0.05)。治疗两周后TBiL及PT改善情况,治疗组明显好于对照组(P<0.001)。治疗致病情稳定的病例中,治疗组的平均住院日明显少于对照组(P<0.001),而治疗组平均费用与对照组比较无显著差异(P>0.05)。结论病毒性肝炎高胆红素血症,且有明显乏力及消化道症状,尤其是内科综合治疗仍未能控制病情者,即使未达到重型肝炎诊断标准,也应尽早行人工肝血浆置换治疗。Objective To study the effect and price relation in virus hepatitis with hyperbilirubinemia treated by ALSS. Methods They are divided into two groups based on the 46 patients who are just hospitalized.Each patient＇s TBil is 10 times high than the upper limit of normal value.And they all have evident hypodynamia and digestive tract symptom with PTA〉40%.One was treated by ALSS plus general treatments and the other （the control group） was only treated by general treatments,The change of TBil and PT after two weeks,effective rate, hospitalization time and average cost of the patients who are in stable condition after the treatments were observed.Results The ALSS group is far better than the control group at the prevention of severe hepatitis, and reducing the risk of complication.The ALSS group is much better than the control group at TBil and PT after two weeks （p〈0.001）.The effective rate of ALSS group is significantly higher than the control group （p〈0.05）.Concerning the patients who are in stable condition after the treatments,the hospitalisation time was significantly shorter than that of the control group （p〈0.001）.There is no significant difference of average cost between the two groups （p〉0.05）.Conclusion the virus hepatitis with hyperbilirubinemia,obvious hypodynamia and digestive tract symptom should be treated by ALSS （plasma exchange）,too, esp when it can not be controlled by general treatment though it has not been diagnosed as severe hepatitis yet.

关 键 词：人工肝 血浆置换 治疗方法 病毒性肝炎 高胆红素血症 

分 类 号：R512.6[医药卫生—内科学] R457[医药卫生—临床医学]