摘要
目的分析血浆置换联合血液滤过治疗爆发性药物性肝炎的疗效。方法回顾性分析,2014年1月—2018年2月,单纯的血浆置换治疗爆发性药物性肝炎31纳入对照组,血浆置换联合血液滤过28例纳入联合组。对比疗效、并发症、不良反应发生情况、症状与体征改善时间、住院时间、血浆置换次数。结果联合组无效率、不良反应发生率分别为3.6%、3.6%,对照组16.1%、6.5%,差异无统计学意义(χ~2=3.448、0.468,P=0.063、0.494>0.05)。联合组严重并发症合计发生率57.1%低于对照组93.5%,差异有统计学意义(χ~2=21.946、P=0.000<0.05)。联合组全身症状消失时间、肝功能明显好转时间、住院时间、血浆置换次数分别为(8.6±3.3)d、(8.5±1.4)d、(24.3±6.1)d、(2.5±0.8)次/人低于对照组(10.5±3.4)d、(10.4±3.4)d、(29.5±5.5)d、(3.2±1.1)次/人,差异有统计学意义(t=2.173、2.752、3.444、2.769,P=0.034、0.008、0.001、0.008<0.05)。结论血浆置换联合血液滤过治疗爆发性药物性肝炎可以缩短病程,降低严重并发症发生风险。
Objective To analyze the efficacy of plasma exchange combined with hemofiltration in the treatment of explosive drug-induced hepatitis. Methods Retrospective analysis, from January 2014 to February 2018, simple plasmapheresis for the treatment of explosive drug-induced hepatitis 31 was included in the control group, and 28 patients with plasmapheresis combined with hemofiltration were included in the combination group. Compare efficacy, complications, adverse reactions,time to symptom and sign improvement, length of hospital stay, and number of plasma exchanges. Results The ineffective rate and adverse reaction rate were 3.6% and 3.6% in the combined group and 16.1% and 6.5% in the control group. The difference was not statistically significant(χ~2=3.448, 0.468, P=0.063, 0.494>0.05). The combined incidence of serious complications in the combined group was 57.1% lower than that in the control group(93.5%), and the difference was statistically significant(χ~2=21.946, P=0.000<0.05). The disappearance time of systemic symptoms, the improvement of liver function,the length of hospital stay, and the number of plasma exchanges in the combined group were(8.6±3.3)d,(8.5±1.4)d,(24.3±6.1)d,(2.5±0.8) times/person, compared with the control group(10.5±3.4)d,(10.4±3.4)d,(29.5±5.5)d,(3.2±1.1) times/person,the difference was statistically significant(t=2.173, 2.752, 3.444, 2.769, P=0.034, 0.008, 0.001, 0.008 < 0.05). Conclusion Plasma exchange combined with hemofiltration for the treatment of explosive drug-induced hepatitis can shorten the course of disease and reduce the risk of serious complications.
作者
李鑫
张竹华
李潘孝
LI Xin;ZHANG Zhu-hua;LI Pan-xiao(Department of Critical Care Medicine,Third Hospital of Zhangzhou City,Zhangzhou,Fujian Province,363000 China;Department of Critical Care Medicine,Ningde Hospital,Fujian Medical University,Ningde,Fujian Province,352000 China)
出处
《中外医疗》
2019年第4期69-71,共3页
China & Foreign Medical Treatment
关键词
药物性肝炎
血液滤过
血浆置换
Drug-induced hepatitis
Hemofiltration
Plasma exchange
