血浆置换术治疗终末期肝病短期疗效的MELD-Na分析  

作　　者：徐磊 方志雄 黄求生 贺朗秋 

机构地区：[1]湘潭市中心医院感染内科,湖南411100

出　　处：《当代医学》2015年第11期1-2,共2页Contemporary Medicine

摘　　要：目的观察MELD-Na(血清钠与终末期肝病模型联合公式)模型评分系统在终末期肝病短期预后的作用,评估血浆置换术在终末期肝病治疗中的疗效。方法选择90例终末期肝病患者随机分为观察组52例和对照组38例,对其进行ME LD-Na评分,并对观察组进行血浆置换术后MELD Na评分,观察3个月内死亡率。结果在PE(血浆置换术)治疗前后总胆红素和INR(国际标准化比值)、凝血酶原时间的变化差异有统计学意义(P<0.05);30<MELD-Na<50的患者经PE治疗后MELD-Na评分显著下降,差异有统计学意义(P<0.05),MELD-Na≥50的患者经PE治疗后3个月时病死率均为100%。结论血浆置换治疗能有效改善肝衰竭患者生化指标和MELD-Na评分。Objective To observe the practical use of the end-stage liver disease MELD-Na scoring system on clinic and therole of plasma exchange on end-stage liver disease. Methods 90 patients were divided randomly into observation group and control group, and they were graded with MELD-Na before and after plasma exchange. The death rate are observed three months later. Results There were obvious exchanges of total serum bilirubin,INR and prothrombin time in the 52 patients with liver failure before and after PE （P〈0.05）; the improvement was found in patients with score less at 30 to 50（P〈0.05）; 12 cases with score higher than 50 were all dead. Conclusion Plasma exchange can significantly improve clinical outcomes of patients with liver failure,especially inthose at early to middle stage disease.

关 键 词：重型肝炎 终末期肝病血清钠 血浆置换 预后 

分 类 号：R575.3[医药卫生—消化系统]