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目的 :回顾分析血浆置换在慢性重型肝炎治疗中的疗效和影响预后的因素。方法 :1999年 5月至 2 0 0 3年 6月用血浆置换治疗慢性重型肝炎患者 32 9例 ,回顾性分析患者临床特点、血浆置换治疗方法和影响疗效的因素。结果 :患者存活 2 16例 (6 5 .6 5 % ) ,死亡 113例 (34.35 % )。讨论 :血浆置换的疗效与患者年龄、病因、肝病严重程度 (凝血酶原活动度、血清胆红素、血清总胆固醇、白蛋白水平 )、甲胎蛋白、内毒素、并发症发生率、器官衰竭数及血浆置换治疗的时机、频率、血浆置换量及组合模式与慢性重型肝炎的预后密切相关 ,该技术改革促进了其临床应用 ;血浆置换治疗慢性重型肝炎的疗效受患者年龄、基础肝病临床分型、病情严重程度、并发症等因素影响。
Objective: To retrospectively analyze the effect of plasma exchange in the treatment of chronic severe hepatitis and the prognostic factors. Methods: From May 1999 to June 2003, 329 patients with chronic severe hepatitis were treated with plasma exchange. The clinical characteristics, plasma exchange therapy and the factors influencing curative effect were retrospectively analyzed. Results: There were 216 cases (65.55%) survived and 113 (34.35%) died. Discussion: The efficacy of plasma exchange correlated with patient age, etiology, severity of liver disease (prothrombin activity, serum bilirubin, serum total cholesterol, albumin levels), alpha-fetoprotein, endotoxin, incidence of complications, organ failure The number and timing of plasma exchange therapy, frequency, plasma exchange volume and combination mode are closely related to the prognosis of chronic severe hepatitis. The technical reform has promoted its clinical application. The efficacy of plasma exchange in the treatment of chronic severe hepatitis is influenced by the age of patients, Type, severity of illness, complications and other factors.