血浆置换联合血液滤过治疗重型肝炎肝性脑病临床观察  

Observation of plasma exchange combined with hemofiltration effect on treating severe hepatitis patients with hepatic encephalopathy

作　　者：李勇忠[1] 符政远[1] 彭吉军[1] 邓英[1] 胡文祥[1] 王黔梅[1] 聂小红[1] 

机构地区：[1]湖南省怀化市第一人民医院,怀化418000

出　　处：《中国血液净化》2003年第11期613-615,共3页Chinese Journal of Blood Purification

摘　　要：目的 探讨血浆置换联合连续静静脉血液滤过治疗重型肝炎并发肝性脑病的疗效。方法 35名重型肝炎肝性脑病患者随机分为治疗组18例,对照组17例,两组均给予综合护肝、促进肝细胞再生、降血氨、脱水防治脑水肿及调整血浆氨基酸谱等治疗,观察肝性脑病不同病期的治疗效果及不良反应。结果 治疗组Ⅰ、Ⅱ、Ⅲ、Ⅳ期肝性脑病有效率分别为100％、100％、100％、50％,总有效率89.0％;对照组Ⅰ、Ⅱ、Ⅲ、Ⅳ期有效率分别为100％、33.4％、33.4％、0％,总有效率41.2％,两组比较有显著性差异(P<0.01)。结论 血浆置换联合连续静静脉血液滤过治疗重型肝炎并发肝性脑病疗效可靠、安全,尤以Ⅰ、Ⅱ、Ⅲ期肝性脑病疗效最好。Objective To investigate the therapeutic effect of plasma exchange (PE) and continuous hemofiltration (CVVH) on treating severe hepatitis patients with hepatic encephalopathy (HE). Methods Thirty - five severe hepatitis patients with HE were randomly devided into therapeutic group and control group. The patients in therapeutic group were given PE and CVVH treatment. All patients were given the same general therapy. We observed the therapeutic effects and the side effects in different HE stage patients. Results The effective rates for stage Ⅰ,Ⅱ,Ⅲ, and IV HE patients in therapeutic group were 100% , 100%, 100% , and 50% respectively. The total effective rate in therapeutic group was 89% . And the effective rates of stage Ⅰ,Ⅱ,Ⅲ,and IV HE patients in control group were 100% ,33.4% ,33.4%, and 0 respectively. The total effective rate in control group was 41.2% . There were significant differences in effective rates between the two groups (P < 0.01). Conclusion The therapeutic effects of PE combined CVVH on treating severe hepatitis patients with HE is dependable and safe, especially for stage Ⅰ,Ⅱ and Ⅲ HE patients.

关 键 词：血浆置换 联合治疗 重型病毒性肝炎 肝性脑病 并发症 连续静静脉血液滤过 

分 类 号：R512.6[医药卫生—内科学] R747.9[医药卫生—临床医学]