人工肝支持系统治疗重型肝炎的疗效评价  

Evaluation of the therapeutic effect of artificial liver support system on severe viral hepatitis

作　　者：江元森[1] 陈幼明[1] 姚集鲁[1] 李学俊[1] 曾彩虹[1] 邓友[1] 邓练贤[1] 陆玮伦[1] 

机构地区：[1]中山医科大学附属第三医院传染病科

出　　处：《中华内科杂志》2000年第2期115-117,共3页Chinese Journal of Internal Medicine

基　　金：广东省自然科学基金!0 0 95 ;1998

摘　　要：目的　探讨应用人工肝支持系统 (ALSS)治疗重型肝炎肝衰竭合并肝性脑病 ,研究其机制及评价疗效。方法　设治疗组和对照组 ,治疗组 5 1例重型肝炎 (重肝 )患者 ,急性、亚急性重肝 17例 ,慢性重肝 30例 ,酒精性重肝 2例 ,钩体病黄疸型重肝 1例 ,肝豆状核病肝衰竭 1例。在综合护肝治疗基础上同时给予ALSS治疗。对照组 39例重肝患者 ,急性、亚急性重肝 8例 ,慢性重肝 31例 ,仅给予综合护肝治疗。结果　治疗组急性、亚急性重肝治愈好转率为 70 6 % ,对照组为 2 5 0 % ;治疗组慢性重肝治愈好转率为 43 3% ,对照组为 6 5 %。两组差异有显著性 (P <0 0 1)。ALSS降低了重型肝炎的病死率。治疗组中 5例进行肝移植 ,4例存活 ;其中 1例反复肝性脑病患者经 2 0次ALSS治疗后 ,成功地进行了肝移植并存活。结论　ALSS为重型肝炎的治疗提供了较为安全、有效的手段 ,也为肝移植的开展提供了条件。ALSS对重型肝炎肝衰竭的早期疗效较好。Objective To investigate the therapeutic effect of artificial liver support system (ALSS) on severe viral hepatitis with liver function failure and hepatic encephalopathy and to evaluate the relationship between its mechanism and therapeutic effect. Methods The patients in the present study were allocated either into a treatment group or a control group, The treatment group consisted of 51 patients (mean age 40 5 years) with severe viral hepatitis, with 17 each suffering from acute and subacute severe viral hepatitis and 30 suffering from chronic severe viral hepatitis And two patients of alcoholism severe viral hepatitis, One patient of leptosphrosis icterohemorrhagie severe viral hepatitis One of hepatolenticular degeneration hepatic failure The patients received a combined hepatotheragy with ALSS The control group consisted of 39 patients with severe viral hepatitis, of 8 patients in the group of acute and subacute severe viral hepatitis And 31 patients in the group of chronic severe viral hepatitis The patients received a combined hepatotheragy Results The cure and improvement rate in the group of acute and subacute severe viral hepatitis is up to 70 6%, but that in the control group is 25 0% The cure and improvement rate in the group of chronic severe viral hepatitis is 43 3% and that in the control group is 6 5% There is marked difference between the groups ( P <0 01) and it is worth attempting so as to reduce the mortality of severe viral hepatitis Conclusions ALSS is an effective and safe means to treat severe viral hepatitis and it may be an useful support for liver transplantation

关 键 词：肝功能衰竭 人工肝 支持系统 肝性脑病 

分 类 号：R575.1[医药卫生—消化系统]