目的 探讨前列腺素E1联合血浆置换治疗慢性重型肝炎的疗效.方法 将88例慢性重型肝炎患者完全随机分为治疗组与对照组.治疗组46例,在内科综合治疗的基础上予前列腺素E1联合血浆置换治疗;对照组42例,只予内科综合治疗.观察2组治疗前后的症状体征及相关实验室指标.结果 治疗组经治疗后症状体征均明显好转,总胆红素、ALT、总蛋白、白蛋白、胆碱酯酶、凝血酶原活动度、血氨均改善明显(P＜0.01或P＜0.05).治疗后,2组间除白蛋白水平外,其余各指标均差异有统计学意义(P＜0.05).随访3个月,治疗组总有效率69.6%(32例)、早期有效率79.3%(23例)、中期有效率64.3%(9例),均明显高于对照组的47.6%(20例)、55.6%(15例)、38.5%(5例),差异均有统计学意义(均P＜0.01).结论 前列腺素E1联合血浆置换治疗慢性重型肝炎能明显改善肝功能,明显提高疗效.%Objective To investigate the curative effect, timing and feasibility of prostaglandin E1 combined plasma exchange in treatment of chronic severe hepatitis. Methods Eighty-eight patients with chronic severe hepatitis were randomly divided into treatment group and control group. The treatment group was given prostaglandin E1 combined plasma exchange treatment based on the comprehensive treatment of internal medicine. Control group only had given the internal medicine comprehensive treatment. Results The symptoms and signs of the treatment group were improved after treatments, especially with total bilirubin, cholinesterase, prothrombin activity, NH3 ( P ＜ 0.01,P ＜ 0.05 ). After treatment, except for albumin, the others indicators of the two groups had significant difference ( P ＜ 0.05). Follow-up for three months, the total effective rate of the treatment group was 69.6% ( 32cases ), early effective rate was 79.3% (23 cases), mid-term effective rate was 64.3% (9 cases) were all significantly higher than those of control group [47.6% (20 cases), 55.6% ( 15 cases), 38.5% (5 cases)] (P ＜ 0. 01 ).Conclusion Prostaglandin E1 combined with plasma exchange in treatment of chronic severe hepatitis can improve the liver function and survival rate significantly.
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