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摘要: 目的观察连续性血液滤过(CVVH)治疗重型肝炎合并肝性脑病的临床疗效。方法将32例重型肝炎合并肝性脑病患者随机分为两组。治疗组:内科综合疗法+CVVH。对照组:内科综合疗法。治疗前后分别检测肝肾功能、血氨、TNF和IL—6等。结果治疗组、对照组患者的清醒率分别为75.0%和31.3%。CVVH治疗后血清尿素氮、肌酐、氨、TNF及IL-6比对照组明显下降(P<0.05)。血清胆红素、TBA下降与对照组比较无显著性差异(P>0.05)。治疗组肝性脑病Ⅰ-Ⅱ期患者的存活率明显高于Ⅲ-Ⅳ期(P<0.05)。结论CVVH是辅助治疗重型肝炎合并肝性脑病的有效方法,早期治疗能进一步提高疗效。
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关键词:
- 连续性血液滤过(CVVH) /
- 重型肝炎 /
- 肝性脑病
Abstract: Objective To observe the curative effect of continuous ven-venous hemofiltration on gravis type hepatitis combined with hepatic encephalopathy patient.Methods 32 patients with gravis type hepatitis combined with hepatic encephalopathy patient were divided into 2 groups, Therapy group:medical combined therapy+ CVVH.Control group:medical combined therapy.Liver renal function, blood ammonia, TNF and IL-6 were detected before and after therapy.Results The awake rate of therapy group and control group were 75.0% and 31.3%separately.Serum urea nitrogen, creatinine, amonia, TNF and IL-6 were decreased obviously compared with control group (P<0.05) .The persistence of patients with hepatic encephalopathy disease inⅠ-Ⅱstage in thrapy group, which was higher than of patients with Ⅲ-Ⅳstage (P<0.05) .Conclusion CVVH was the modus operandi in curing the patients with gravis type hepatitis combined with hepatic encephalopathy hepatic encephalopathy patient and early treatment could develop the curative effect further. -
[1]中华医学会.病毒性肝炎防治方案[J].传染病信息, 2000, 13 (4) :141-150. [2]徐微, 谢志萍, 裴豪, 等.人工肝支持系统治疗慢性重症肝炎34例临床研究[J].中国实用内科杂志, 2004, 24 (1) :48. [3]甘建和, 赵卫峰, 徐杰, 等.人工肝支持系统治疗重型肝炎的临床研究[J].江苏医药, 2001, 12 (2) :901-903.
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