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1、血浆吸附系统治疗早中期重型肝炎的临床探讨【摘要】目的：探讨早中期重型肝炎采用离子交换树脂和中性大孔树脂双重血浆吸附系统治疗临床效果。方法：选取早中期重型肝炎患者40例，均为笔者所在医院2015年1月-2016年1月收治，采用双重血浆吸附系统治疗，对比治疗前后临床症状改善情况及肝功能指标等变化。结果：40例早中期重型肝炎病例,采用血浆吸附系统治疗后，临床症状均有程度不等的改善，表现为腹胀缓解、精神好转、食欲增加.乏力减轻，出血倾向不明显。相较治疗前，治疗后患者CHE明显升高，TBA、ALT、TB、AST指标明显下降，差异均有统计学意义(P<0.05)oALB相对升高,但差异无统计意义(P>0
2、.05)o相较治疗前，治疗后PTA升高,PT缩短，NH3降低，差异均有统计学意义(P<0.05),外周PLT、Hb、WBC变化不明显(P>0.05)o不良反应中，因管路凝血治疗提前终止1例次，心率加快、血压下降1例次，调整血流速度后恢复。存活36例，占90%,死亡4例，占10%。其中因重症肺炎死亡1例，消化道出血死亡1例，肝性脑病死亡2例。结论：针对临床收治的早中期重型肝炎病例，采用血浆吸附系统治疗，可显著改善肝功能，且具较高临床安全性。【关键词】血浆吸附；早中期；重型肝炎；临床观察中图分类号R512.6文献标识码A文章编号1674-6805(2016)23-0006-03[Abstrac
3、t】Objective：Toinvestigatetheclinicaleffectofdualplasmaadsorptionsystemofionexchangeresinandneutralmacroporousresininearlyandmiddlestageofseverehepatitis・Method：FromJanuary2015toJanuary2016,40casesofearlyandmiddlestageseverehepatitiswereselectedfromourhospital,theyweretreatedwithdoubleplasmaadsorpt
4、ionsystem,theimprovementofclinicalsymptomsandliverfunctionindexeswerecomparedbeforeandaftertreatment.Result：Thepatientswithearlyandmiddlestageseverehepatitisweretreatedwithplasmaadsorptionsystem,andtheclinicalsymptomswereimprovedindifferentdegree・Manifestedasabdominaldistension,mentalimprovement,i
5、ncreasedappetite,fatigue,lackofbleedingtendencywerenotobvious・Comparedwithbeforetreatment,aftertreatment,patientswithCHEweresignificantlyhigher,TBA,ALT,TB,ASTindicatorsweresignificantlydecreased,therewerestatisticaldifferences(P<0.05).ALBwasrelativelyelevated,buttherewasnostatisticalsignificance(P
6、>0.05)・Comparedwithbeforetreatment,PTAwasincreasedaftertreatment,thePTwasshortened,NH3wasdecreased,therewerestatisticallysignificant(P<0.05),peripheralPLT,WBCandHbchangednotsignificantly(P>0.05)・Adversereactions,duetotheearlyterminationofthepipelinecoagulationtreatmentin1case,heartrate,bloodpressu
7、redecreasedby1time,therecoveryafterbloodflowvelocityadjustment.Survivalof36cases,accountingfor90%,4casesofdeath,accountingfor10%・Amongthem,1casediedofseverepneumonia,1casediedofgastrointestinalbleeding,2casesdied
