CAJ | 학술논문

【目的】探讨人工肝血浆置换技术治疗重症肝炎患者的临床效果和常见不良反应。【方法】本院180例重症肝炎患者按照随机原则分为治疗组和对照组，每组90例。对照组90例采取护肝降酶及防治并发症等内科综合疗法，治疗组在对照组基础上，联合人工肝血浆置换术治疗，比较两组患者治疗前后的血液生化指标变化及常见不良反应，同时观察治疗组中急性重型肝炎、亚急性重型肝炎、慢加急性重型肝炎、慢性重型肝炎的治疗效果差异。【结果】治疗组总有效率为81．11％，对照组总有效率为52．22％，二者比较差异有显著性（ P ＜0．01），治疗组经人工肝血浆置换术治疗后谷丙转氨酶（ALT ）、谷草转氨酶（AST ）、总胆红素（TBIL）、白蛋白（ALB）；凝血酶原活动（PTA）；胆碱酯酶（ChE）与对照组比较差异有显著性（ P ＜0．01）。治疗组中各型肝炎治疗有效率从高到低依次为亚急性重型肝炎有效率96．29％，慢加急性重型肝炎91．17％，慢性重型肝炎66．66％，急性重型肝炎35．71％，各类患者疗效差异明显。治疗组患者不良反应有皮肤瘙痒和皮疹、四肢痉挛、鼻腔出血、肢体麻木等，经对症处理后均好转。【结论】人工肝血浆置换术是重型肝炎患者安全有效的治疗选择，尤其对亚急性重型肝炎疗效更佳。
【목적】탐토인공간혈장치환기술치료중증간염환자적림상효과화상견불량반응。【방법】본원180례중증간염환자안조수궤원칙분위치료조화대조조，매조90례。대조조90례채취호간강매급방치병발증등내과종합요법，치료조재대조조기출상，연합인공간혈장치환술치료，비교량조환자치료전후적혈액생화지표변화급상견불량반응，동시관찰치료조중급성중형간염、아급성중형간염、만가급성중형간염、만성중형간염적치료효과차이。【결과】치료조총유효솔위81．11％，대조조총유효솔위52．22％，이자비교차이유현저성（ P ＜0．01），치료조경인공간혈장치환술치료후곡병전안매（ALT ）、곡초전안매（AST ）、총담홍소（TBIL）、백단백（ALB）；응혈매원활동（PTA）；담감지매（ChE）여대조조비교차이유현저성（ P ＜0．01）。치료조중각형간염치료유효솔종고도저의차위아급성중형간염유효솔96．29％，만가급성중형간염91．17％，만성중형간염66．66％，급성중형간염35．71％，각류환자료효차이명현。치료조환자불량반응유피부소양화피진、사지경련、비강출혈、지체마목등，경대증처리후균호전。【결론】인공간혈장치환술시중형간염환자안전유효적치료선택，우기대아급성중형간염료효경가。
[Objective] To explore the therapeutic efficacies and common adverse reactions of artificial liver plasmapheresis for patients with severe hepatitis .[Methods]A total of 180 patients were recruited and divided randomly into treatment (n=90) and control (n=90) groups .The control group received conventional com‐prehensive therapy while artificial liver plasma replacement was offered for the treatment group .The changes of clinical symptoms and blood biochemical parameters were compared for two groups before and after compre‐hensive therapy .And the clinical efficacies and common adverse reactions of artificial liver plasmapheresis were observed for patients of acute severe hepatitis ,subacute severe hepatitis ,acute‐on‐chronic severe hepatitis and chronic severe hepatitis .[Results]The overall efficacious rate was 81 .11% in treatment group versus 52 .22%in control group .And there was statistically significant difference (p<0 .01) .After artificial liver plasmaph‐eresis ,statistically significant inter‐group differences existed in alanine transaminase (ATL) ,aspartate trans‐aminase (AST ) ,total bilirubin (TBIL) ,prothrombin time activity (PTA) and acetylcholinesterase (ChE) ( P<0 .001) .In treatment group ,acute severe hepatitis had an efficiency rate of 35 .71% ,subacute severe hepa‐titis 96 .29% ,acute‐on‐chronic severe hepatitis 91 .17% and chronic severe hepatitis 66 .66% .And there were significant differences in therapeutic efficacies for various subtypes of patients .Adverse reactions of skin itch‐ing ,rashes ,spastic quadriplegia ,nasal bleeding and limb numbness improved after taking symptomatic meas‐ures .[Conclusion]Artificial liver plasmapheresis is both efficacious and safe for patients with severe hepatitis .