CAJ | 학술논문

目的：探讨血浆置换联合胆红素吸附术在重症肝炎中的应用疗效。方法重症肝炎患者中随机抽取30例使用血浆置换联合胆红素吸附术患者及仅内科保守治疗的30例患者，分为治疗组和对照组。两组患者入院后均给予同样的内科治疗，治疗组在内科治疗的基础上实施血浆置换联合胆红素吸附治疗，统计治疗组与对照组治疗后第2、4周谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)、白蛋白(ALB)、胆碱酯酶(CHE)、总胆固醇(TC)、凝血酶原活动度(PT%)等变化情况，观察患者精神、食欲、乏力、腹胀等一般情况变化，统计两组患者的最终疗效。结果治疗组无论在症状、肝功能好转还是康复时间方面较对照组都有明显的优势，在第2、4周ALT、AST、TBIL都有明显下降(P<0.05、P<0.05、P<0.01)， CHE、PT%、TC明显升高(P<0.01、P<0.01、P<0.05)，总有效率93.3%，明显高于对照组73.3%(P<0.05)。结论血浆置换联合胆红素吸附能明显改善重症肝炎患者症状及肝功能，提高治愈率。
목적：탐토혈장치환연합담홍소흡부술재중증간염중적응용료효。방법중증간염환자중수궤추취30례사용혈장치환연합담홍소흡부술환자급부내과보수치료적30례환자，분위치료조화대조조。량조환자입원후균급여동양적내과치료，치료조재내과치료적기출상실시혈장치환연합담홍소흡부치료，통계치료조여대조조치료후제2、4주곡병전안매(ALT)、곡초전안매(AST)、총담홍소(TBIL)、백단백(ALB)、담감지매(CHE)、총담고순(TC)、응혈매원활동도(PT%)등변화정황，관찰환자정신、식욕、핍력、복창등일반정황변화，통계량조환자적최종료효。결과치료조무론재증상、간공능호전환시강복시간방면교대조조도유명현적우세，재제2、4주ALT、AST、TBIL도유명현하강(P<0.05、P<0.05、P<0.01)， CHE、PT%、TC명현승고(P<0.01、P<0.01、P<0.05)，총유효솔93.3%，명현고우대조조73.3%(P<0.05)。결론혈장치환연합담홍소흡부능명현개선중증간염환자증상급간공능，제고치유솔。
Objective To explore the efficacy of combined application of plasmapheresis and bilirubin adsorption in patients in severe hepatitis.Methods Patients with severe hepatitis were randomly selected, and there were 30 patients undergone plasmapheresis and bilirubin adsorption, and 30 patients treated by conservatively medical therapy. These cases were divided into treatment group and control group. After admission, both groups received the same medical treatment. The treatment group was treated with additional plasmapheresis and bilirubin adsorption. Changes of alanine aminotransferase (ALT), aspartate transaminase (AST), total bilirubin (TBIL), albumin (ALB), cholinesterase (CHE), total cholesterol (TC), prothrombin time (PT%) after 2 and 4 weeks of treatment were compared. Mental change, loss of appetite, fatigue, bloating and other general changes of patients were observed. The ultimate effect was summarized.Results The treatment group had more advantages in symptoms, liver function improved terms or recovery time than the control group, and ALT, AST, TBIL after 2 and 4 weeks of treatment had decreased significantly (P<0.05,P<0.05,P<0.01), CHE, PT%, and TC increased significantly (P<0.01,P<0.01,P<0.05). The total efficiency was 93.3%, which was significantly higher than 73.3% (P<0.05).Conclusion Plasmapheresis and bilirubin adsorption can significantly improve symptoms in patients with severe hepatitis and liver function, while improving the cure rate.