血浆置换联合连续性肾脏替代治疗重症肝炎临床观察  

Clinical Observation of PE Combined with CRRT in Treatment of Patients with Serious Hepatitis

作　　者：郭强[1] 陈燕春[1] 王平[1] 

机构地区：[1]成都市第五人民医院感染性疾病科,成都611130

出　　处：《解放军医药杂志》2017年第10期61-63,共3页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：四川省医药卫生科研项目(10043)

摘　　要：目的探讨血浆置换(PE)联合连续性肾脏替代治疗(CRRT)对重症肝炎患者血清炎性介质及预后的影响。方法选取成都市第五人民医院2014年6月—2016年12月收治的重症肝炎90例,按治疗方法分为A、B、C组,每组30例。C组予以PE+内科常规治疗,A组在C组基础上给予8~12 h 20 L CRRT,B组在C组基础上给予20~24 h 40 L CRRT。观察3组治疗前后血清炎性介质变化情况及预后。结果 3组治疗后血清炎性因子水平均低于治疗前,且A、B组低于C组(P<0.05)。随访半年后,3组总好转率比较差异无统计学意义(P>0.05)。结论 PE联合CRRT治疗重症肝炎可降低患者血清炎性介质表达水平,提高治疗效果,不同剂量的置换液对CRRT治疗效果无明显影响。Objective To investigate effects of plasma exchange （ PE） combined with continuous renal replace-ment therapy （ CRRT） on serum inflammatory mediators and prognosis in patients with serious hepatitis. Methods A to-tal of 90 patients with serious hepatitis admitted during June 2014 and December 2016 were divided into group A, B and C （ n=30 for each group） according to therapeutic methods. Group C received PE and routine treatment of internal medi-cine, and group A was treated with 20 L CRRT for 8-12 h on the basis of treatment for group C, while group B was treated with 40 L CRRT for 20-24 h on the basis of treatment for group C. Changes of serum inflammatory mediators and prog-noses were observed before and after treatment in three groups. Results After treatment, levels of serum inflammatory mediators were significantly decreased compared with those before treatment in three groups, and the levels in group A and B were significantly lower than those in group C （ P〈0. 05 ） . There were no significant differences in the total im-provement rate among three groups （P〉0. 05）. Conclusion Plasma exchange combined with continuous renal replace-ment therapy in treatment of patients with serious hepatitis can reduce levels of serum inflammatory mediators and increase therapeutic efficiency, and different doses of replacement fluid have no obvious effects on CRRT effectiveness.

关 键 词：重症肝炎 血浆置换 连续性肾脏替代 炎性介质 预后 

分 类 号：R575.1[医药卫生—消化系统]