血浆置换型人工肝联合内科治疗乙肝肝衰竭效果观察
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[摘要] 目的 探讨血浆置换型人工肝联合内科治疗乙肝肝衰竭的临床疗效。方法 选取2005年1月~2010年9月本科收治的乙肝肝衰竭病例共109例，按照患者的意愿分为对照组(行单纯内科综合治疗)和治疗组(单纯内科综合治疗+人工肝治疗)，治疗后3个月对两组患者的总体疗效、不良反应、肝功能进行分析和比较。结果 治疗组总有效率明显高于对照组(76.7%VS 55.1%)，治疗组治疗后肝功能改善优于对照组，两组比较差异有统计学意义(P<0.05)；两组患者不良反应发生率比较，差异无统计学意义(P>0.05)。结论 血浆置换型人工肝治疗乙肝肝衰竭效果显著，是安全、有效的方法。
[关键词]血浆置换型人工肝；乙肝；肝衰竭
[中图分类号] R512.6+2[文献标识码] B [文章编号]1673-9701(2011)21-29-02
The Effect of Plasma Exchange Artificial Liver Combined with Medical in Treatment of Liver Failure of Hepatitis B
HU Weiyue1 LI Jin1LUO Hong xia1ZHOU Lianxin1 HU Jinrui2 CAO Xuejue2
1.Department of Infectious Disease, the First People’s Hospital of Yongkang City in Zhejiang Province, Yongkang 321300, China;
2. Hemodialysis room , The First People’s Hospital of Yongkang City in Zhejiang Province, Yongkang 321300, China
[Abstract] Objective To explore the effect of plasma exchange artificial liver combined with medical treatment of liver failure of hepatitis B. Methods Form Jan. 2005 to Sep. 2010, 109 cases with liver failure of hepatitis B were divided into control group and treatment group. The control group were given medical treatment, and the treatment group were given plasma exchange artificial liver combined with medical treatment. After 3 months, the clinical effect , untoward effect and liver function were analyzed and compared. Results The total effectiveness in treatment group was higher than control group(76.7%VS 55.1%), the liver function were significantly improved in treatment group than control group(P<0.05). The rate of untoward effect had no significant difference between two groups(P>0.05). Conclusion Plasma exchange artificial liver receive a significant effect treatment of liver failure of hepatitis B. It is a safe and effective method.
[Key words] Plasma exchange artificial liver；Hepatitis B; Liver failure
乙肝肝衰竭是感染科常见危重急症，《肝衰竭诊疗指南》指出肝衰竭的治疗方法包括内科综合治疗、人工肝治疗和肝移植。而单纯内科药物治疗病死率高达50%~80%，人工肝支持系统可暂时替代肝脏的解毒和滤过功能，用以净化血液，改善机体内环境，从而为肝细胞再生及进一步的临床治疗赢得宝贵时间[1]。浙江省永康市第一人民医院感染科自从2005年1月引进并开展血浆置换型人工肝治疗肝衰竭，取得较好疗效，现报道如下。
1 资料与方法
1.1 一般资料
选取2005年1月～2010年9月本科收治的乙肝肝衰竭病例共109例，诊断符合《肝衰竭诊疗指南》标准 ......
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