丁　立　叶晓燕

【摘要】 目的 评价血浆置换治疗重型肝炎的疗效并分析其影响因素。方法 应用血浆置换治疗47例重型肝炎患者，回顾性分析患者的临床特点、疗效及其影响因素。结果 47例患者治愈或好转23例,有效率为48．9%。血浆置换治疗对各型重型肝炎的晚期患者疗效差。患者合并的并发症越多疗效越差。有效率不随血浆置换治疗的次数增加而增高。治疗效果与患者性别及年龄无关。结论 血浆置换是一种治疗重型肝炎的有效方法；提高重型肝炎治愈好转率需早期治疗，积极防治并发症。

【关键词】血浆置换；重型肝炎；疗效；影响因素

Analysis of curative effect and its influencing factors of plasma exchange in the treatment of patients with severe hepatitis

DING Li,YE Xiao-yan.Department of Infectious Diseases Service ，The Fifth Affiliated Hospital of Sun Yat-sen University，Zhuhai,Guangdong，519000，China

【Abstract】 Objective To evaluate the curative effect of plasma exchange in the treatment of patients with severe hepatitis and analyze its influencing factors.Methods 47 patients with severe hepatitis were treated with plasma exchange on the basis of medicine synthesis therapy.The clinical characteristics,the curative effect and its influencing factors of these cases were studied by the retrospective analysis.Results Of47 patients,23 patients were cured or improved,The efficient rate is 48．9%.For the late stage of all types of severe hepatitis,

作者单位：519000珠海，中山大学附属第五医院感染科

the efficacy was bad.The more complications of severe hepatitis were,the worse the curative effect was.The efficient rate of patients did not improve with the increase of therapeutic times.The curative effect have nothing to do with the age and the sex.Conclusion Plasma exchange is an effective therapeutic means for severe hepatitis.In order to improve the efficient rate of patients,we should use this means in early stage and prevent complications actively.

【Key words】Plasma exchange;Severe hepatitis;Curative effect;Influencing factor

为客观评价血浆置换治疗重型肝炎的疗效、分析其影响因素，我们对2003年9月至2007年10月住院的应用血浆置换治疗的47例重型肝炎病例进行了总结，结果报告如下。

1 资料和方法

1．1 一般资料 47例患者为我科2003年9月至2007年10月间应用血浆置换治疗的重型肝炎患者。其中男41例,女6例;年龄18~74岁,平均40．38岁。重型肝炎及其分期的诊断符合2000年(西安)全国病毒性肝炎与肝病学术会议修订的诊断标准^[1]。47例中，急性重型肝炎5例，亚急性重型肝炎早期2例，中期3例，晚期7例，慢性重型肝炎早期13例，中期7例，晚期10例。病因及病原学分布为：单纯乙型肝炎39例，乙型+药肝2例，乙型+戊型+酒肝1例，乙型+丙型1例，戊肝+酒肝2例，未定型肝炎2例。

1．2 治疗方法

1．2．1 内科基础治疗 47例患者给予常规内科基础治疗，如卧床休息,补充足够能量,静滴甘利欣、还原型谷胱甘肽、促肝细胞生长素、门冬氨酸钾镁、前列地尔等药物，补充白蛋白、凝血因子，中医中药等，积极防治并发症。……