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1、血浆置换治疗重型肝炎的临床观察作者：梁碧琴，陆绍强,赵爱香，黎海舰,朱征西单位：广西百色市人民医院，右江民族医学院附属西南医院，广西百色【摘要】目的观察血浆置换(PE)治疗重型肝炎的临床疗效及影响效果的主要因素。方法随机抽取符合病例选择标准的40例患者为治疗组，36例为对照组，两组内科综合治疗相同，治疗组加PE治疗。通过观察两组患者治疗前后临床症状、生化指标等的变化及出院后6个月随访，判断PE的疗效及影响疗效主要因素。结果治疗组治疗后第2、4周ALT、TBIL指标比对照组明显改善(P均治疗组急、慢性患者出院时及出院后6个月随
2、访总有效率明显高于对照组(P<0.01或P<0.05)；治疗组早、中期患者有效率明显高于对照组(PV0.05)；但在晚期，PE治疗组与对照组相比差异无显著性(P>0.05)；出现肝性脑病、上消化道出血、肝肾综合征、自发性腹膜炎等并发症时的治疗有效率差异无显著性(P>0.05)。结论PE治疗重型肝炎疗效肯定，肝病严重程度、病期及并发症为影响疗效主要因素，掌握治疗时机是提高疗效的关键。【关键词】重型肝炎/治疗；血浆置换Clinicalobservationofplasmaexchangeintreatmentofse
3、verehepatitisLIANGBi-qin,LUShao-qiang,ZHAOAi-xiang,LIHai-jian,ZHUZheng-xi,LUFeng-ling,LIJin-xiu(BaisePeople'sHospital,theAffiliatedSouth-westHospitalofYoujiangMedicalCollegeforNationalities,Baise,Guangxi533000,China)Abstract:ObjectiveTooutlinetheclinicalefficacyofp
4、lasmaexchange(PE)forpatientssufferedfromgravishepatitis,andanalyzethemainfactorswhichaffecttheoutcome.MethodsFortypatientswerechosenastherapeuticgroupandthirty-sixascontrolgrouprandomly.Bothgroupsreceivedconventionalcomplextreatment,inaddition,thetherapeuticgroupre
5、ceivedPEaswell.Mainclinicalsymptoms,bloodbiochemicalindicesbeforeandaftertreatmentandtheoutcomeof6-monthfollow-upwererecordedforjudgingclinicalresultsanditsaffectedfactors.ResultsThetherapeuticgroupinALTandTBILindicesimprovedappreciablythancontrolgroup2and4weeksaft
6、ertreatment,therewasstatisticalsignificantdifterence(P<0.01).Patientswithacuteorchronichepatitisintherapeuticgrouphadbetterefficacyratiothanthoseincontrolgroupattheendoftreatmentand6-monthfollow-up,therewasstatisticaldifference(P<0.01orP<0.05).Early-or-mid
7、stagepatientsinthetherapeuticgrouphadbetterefficacyratiothanthoseincontrolgroup(P<0.05).Butforadvancedpatients,therewasnostatisticaldifterenceinefficacyratebetweentherapeuticgroupandcontrolgroup(P>0.05).Theefficacyratiodidnotdifferbetweenthetwogroupsforpatien
8、tsassociatedwithhepaticencephalopathy,uppergastrointestinalhemorrhage,hepatorenalsyndromeandprimaryperitonitis(P>0.05).ConclusionPEisaneffecti
