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重型病毒性肝炎(简称重肝)病情复杂,肝功能损伤严重,合并症多,治疗困难,国外报道重肝病死率为60%~80%,国内1975年以后报道为65%左右。本组共收治重肝34例,病死率为47%。现将诊治体会介绍如下。 临床资料 一、一般资料:4年共收治34例重肝病人,其中急性肝坏死1例;亚急性重肝15例;慢性重肝18例,男性26例,女性8例。患病年龄5~60岁,其中31~50岁占19例。 二、主要症状和体征:33例早期表现均有高度疲乏无力、食欲不振、腹胀、深度黄染。有出血倾向者15例,有腹水者29例。出现肝脑综合征者16例;腹腔感染者14例;革兰氏阴性杆菌败血症者5例;上消化道出血者10例;肝肾综合征者10例;神经精神症状1例。
Severe viral hepatitis (referred to as the liver) complex, severe liver damage, complications, treatment difficulties, foreign reports of severe hepatitis mortality of 60% to 80%, after 1975 reported about 65%. The group received a total of 34 cases of severe hepatitis, the case fatality rate was 47%. Now diagnosis and treatment will be introduced as follows. Clinical data First, the general information: 4 years were treated a total of 34 cases of patients with severe liver disease, of which 1 case of acute liver necrosis; 15 cases of subacute severe hepatitis; 18 cases of chronic severe hepatitis, 26 males and 8 females. Sick age of 5 to 60 years, of which 31 to 50 years old accounted for 19 cases. Second, the main symptoms and signs: 33 cases of early performance are highly tired and weak, loss of appetite, bloating, depth yellow dye. 15 cases of bleeding tendency, 29 cases of ascites. 16 cases of hepatopulmonary syndrome; 14 cases of intra-abdominal infection; Gram-negative bacilli in 5 cases; upper gastrointestinal bleeding in 10 cases; liver and kidney syndrome in 10 cases; neuropsychiatric symptoms in 1 case.