血浆置换联合持续性血液透析滤过治疗重型肝炎的临床研究  

Clinical Research of Plasmapheresis and Continuous Hemodialysis Filtration for the Treatment of Severe Hepatitis

作　　者：戴小灵[1] 侯志琴[1] 朱兴华[2] 何小珊[1] 钟远辉[1] 

机构地区：[1]梅州市人民医院感染科,广东梅州514031 [2]梅州市人民医院血透中心,广东梅州514031

出　　处：《医学综述》2015年第14期2678-2680,共3页Medical Recapitulate

摘　　要：目的研究血浆置换(PE)联合持续性血液透析滤过(CHDF)治疗重型肝炎的效果。方法将2011年2月至2014年5月梅州市人民医院感染科收治的120例重型肝炎患者按照随机数字表法分为三组:A组(38例)采用PE+综合内科治疗,B组(42例)采用PE+CHDF+综合内科治疗,C组(40例)采用综合内科治疗。比较各组的临床疗效、生化指标变化及近期生存率情况。结果 B组总有效率为95.2%,明显高于A组(68.4%)和C组(52.5%)(P<0.01)。治疗后三组患者肝肾功能等生化指标均较治疗前改善,且B组改善程度最大(P<0.01),而A组改善程度较C组明显(P<0.01)。B组症状改善率为100.0%,明显高于A组(73.7%)和C组(45.0%)(P<0.01)。B组患者生存率为78.6%,明显高于A组(47.6%)和C组(35.0%)(P<0.01)。结论 PE联合CHDF治疗重型肝炎,疗效确切,可有效改善临床症状和肝肾功能,提高近期生存率,改善患者预后。Objective To study the effect of plasmapheresis （ PE ） and continuous hemodialysis filtra-tion （ CHDF） for the treatment of severe hepatitis.Methods A total of 120 patients with severe hepatitis admitted to the Guangdong Meizhou People′s Hospital from Feb.2011 to May 2014 were divided into group A,B,C according to random-number table method.Group A：38 cases,using PE ＋comprehensive medical treatment;group B：42 cases,using PE ＋CHDF ＋comprehensive medical treatment;group C：40 cases, with comprehensive medical treatment.The clinical efficacy,changes of biochemical indicators and short-term survival rate of the three groups were observed.Results After treatment,the effect of group B（95.2%） was highest and significantly higher than that in group A（68.4%）and group C（52.5%）（P〈0.01）.The liver and kidney functions of the three groups such as biochemical index was improved from before treatment ,and group B had the most significant improvement （P〈0.01）,group A was better than group C（P〈0.01）.The symptoms improvement of group B （ 100.0%） was obviously higher than that of group A （ 73.7%） and group C （45.0%）（P〈0.01）.Group B′s survival rate（78.6%）was obviously higher than that of group A （47.6%） and group C（35.0%）（P〈0.01）.Conclusion PE combined with CHDF treating severe hepa-titis has a good curative effect,and can effectively improve the clinical symptoms,the function of liver and kidney,the recent survival rate and the prognosis.

关 键 词：重型肝炎 血浆置换 血液透析滤过 

分 类 号：R55[医药卫生—血液循环系统疾病]