单纯血浆置换和血浆置换联合血液滤过治疗重症肝炎的疗效观察

摘要

ObjectiveTo compare the artificial liver blood plasma exchange(PE)united hemofiltration(HF)in the treatment of various acute or chronic severe hepatitis in clinical curative effect observation.Methods To 95 cases from 2011 to 2014 in our hospital with severe hepatitis were randomly divided into 3 groups,control group 30 cases of internal medicine comprehensive treatment,PE group of 31 cases on the basis of the above treatment with PE, the third group of 34 cases on the basis of the PE and HF,compare the three groups of patients with the biochemical indexes change and total effective rate.ResultsPE and PE+HF group after treatment serum prealbumin(PA),cholinesterase(ChE),prothrombin activity(PTA)are higher,total bilirubin(TBIL),alanine aminotransferase(ALT)and aspartate aminotransferase(AST)decreased(P<0.05),suggesting the biochemical indexes were improved,PE group total effective rate 51.6%,PE+79.4% HF group,control group 36.7%. Above al PE+HF group total effective rate was higher than the control group,the difference was statisticaly significant(χ2=12.072,P<0.01).Conclusion PE joint HF curative effect is better than that of plasma exchange alone for the treatment of severe hepatitis.%目的：比较人工肝血浆置换（PE）联合血液滤过（HF）在治疗各类急慢性重症肝炎时的临床疗效观察。方法将我院2011年～2014年的95例住院重症肝炎患者随机分成3组，对照组30例内科综合治疗，PE组31例在上述治疗基础上加PE，第三组34例在PE基础加HF，对比3组患者各项生化指标变化及总有效率。结果 PE组和PE+HF组治疗后血清前白蛋白（PA）、胆碱脂酶（ChE）、凝血酶原活性（PTA）均升高，总胆红素（TBIL）、丙氨酸转氨酶（ALT）及天冬氨酸转氨酶（AST）均下降（P＜0.05），提示生化指标等均改善。PE组总有效率51.6％；PE+HF组79.4％，对照组36.7％。综上所述PE+HF组总有效率高于对照组，差异有统计学意义（χ2=12.072，P＜0.01）。结论PE联合HF治疗重症肝炎的疗效优于单用血浆置换。