資源描述:
《血漿置換治療重型肝炎的臨床觀察.doc》由會(huì)員上傳分享,免費(fèi)在線閱讀,更多相關(guān)內(nèi)容在工程資料-天天文庫(kù)。
1、血漿置換治療重型肝炎的臨床觀察作者:梁碧琴,陸紹強(qiáng),趙愛香,黎海艦,朱征西單位:廣西百色市人民醫(yī)院,右江民族醫(yī)學(xué)院附屬西南醫(yī)院,廣西百色【摘要】目的觀察血漿置換(PE)治療重型肝炎的臨床療效及影響效果的主要因素。方法隨機(jī)抽取符合病例選擇標(biāo)準(zhǔn)的40例患者為治療組,36例為對(duì)照組,兩組內(nèi)科綜合治療相同,治療組加PE治療。通過觀察兩組患者治療前后臨床癥狀、生化指標(biāo)等的變化及出院后6個(gè)月隨訪,判斷PE的療效及影響療效主要因素。結(jié)果治療組治療后第2、4周ALT、TBIL指標(biāo)比對(duì)照組明顯改善(P均治療組急、慢性患者出院時(shí)及出院后6個(gè)月隨
2、訪總有效率明顯高于對(duì)照組(P<0.01或P<0.05);治療組早、中期患者有效率明顯高于對(duì)照組(PV0.05);但在晚期,PE治療組與對(duì)照組相比差異無顯著性(P>0.05);出現(xiàn)肝性腦病、上消化道出血、肝腎綜合征、自發(fā)性腹膜炎等并發(fā)癥時(shí)的治療有效率差異無顯著性(P>0.05)。結(jié)論P(yáng)E治療重型肝炎療效肯定,肝病嚴(yán)重程度、病期及并發(fā)癥為影響療效主要因素,掌握治療時(shí)機(jī)是提高療效的關(guān)鍵?!娟P(guān)鍵詞】重型肝炎/治療;血漿置換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