摘要
目的拟对急性重型戊型肝炎患者人工肝治疗后总胆红素指标及各临床指标进行研究,观察治疗前后临床症状、体征、血生化指标的变化,探讨人工肝-血浆置换(PE)和熊去氧胆酸联合治疗急性重型戊型肝炎的疗效,为临床治疗急性重型戊型肝炎提供客观依据。方法选择96例患者随机分为三组,所有患者入院后常规检测血生化、血常规、凝血酶原时间、心电图和腹部B超等。每次人工肝治疗前(当日晨空腹)后(次日晨空腹)抽血检测生化全套、凝血酶原时间等指标,分析术后总胆红素的清除率及凝血酶原时间改变。同时观察患者临床症状、体征变化。结果 A组及B组患者每次经过PE治疗后临床症状均有不同程度的缓解,乏力及恶心、腹胀症状减轻,食欲增加。PE治疗前后A组及B组多数患者胆红素明显下降,白蛋白有所增加,凝血酶原时间缩短,胆碱酯酶数值上升,经t检验治疗前后有高度显著的差异性(P<0.01)。PE治疗2周后A、B治疗组和对照组C组之间比较,A组、B组、C组患者治疗后总有效率分别为23%、29%,8%,B组高于A组,明显高于C组,经统计学χ2检验有显著差异性(P<0.001)。结论人工肝-血浆置换治疗后多数临床症状均经迅速缓解,术后检测血清胆红素明显降低、凝血酶原时间缩短、胆碱脂酶活力增加,提示肝脏功能改善明显。另外总有效率B组高于A组,提示加用熊去氧胆酸口服具有更好的保护肝细胞,促进胆汁排泄的作用。
ObjectiveIn order to find out the treatment effects of the method of combining the PE and UDCA in curing the acute HEV and provide some objective evidence. I do my research by observing the patients’clinical symptoms ,signs, and serum biochemical indexes before and after their treatment and analyzing their total bilirubin indexes and other clinical indexes.Method First,96 patients are divided into three groups at random, and al of them have their blood biochemistry, blood routine examination, thrombin time test,electrocardiogram and B-type ultrasonic tested after they are admited into the hospital. Then I examine the patients’biochemical items and thrombin time tests before （in the morning they are treated and with breakfast）and after（the next morning without breakfast） the ALSS, and analyze the clearance ratio of the total bilirubin indexes and the changes of thrombin time. I also observe changes of the patients’clinical symptoms and signs.Results Patients in group A and group B aleviate their symptoms in different degrees each time they receive PE treatment. Their symptoms of lacking in strength, nausea, and abdominal distension have been relieved while their appetite has been increased. After the PE treatment, the total bilirubin indexes of most of the patients in group A and B have been decreased obviously,and the numbers of the albumin have been increased,the thrombin times have been shortened,and the cholinesterase indexes have been increased. According to thet-test, there are great differences before and after the treatment（P〈0.01）.After a two-week PE treatment, I compare the experimental group （A and B） with the control group and find that the effective rates in group A and group B are 23% and 29%, which are higher than that of group C（P〈0.001）.Conclusion Most of the clinical symptoms have been relieved with the treatment of the PE. The serum bilirubin has been decreased, the thrombin time has been shortened, the cholinesterase has been stimulated and the liver functions have
出处
《中国医药指南》
2014年第28期8-10,共3页
Guide of China Medicine
关键词
人工肝
戊型肝炎
熊去氧胆酸
Artificial extracorporeal liver support
HEV
Ursodesoxycholic acid
