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暴发性肝炎并发第4期肝昏迷的患者,尽管采取各种治疗措施,病死率仍很高。据报道尸检50％以上有脑水肿。作者曾见6例肝昏迷4期的暴发性肝炎患者,年龄18～25岁,其中4例HBsAg阳性。入院时凝血酶原时间指数为18～25％。所有患者尽管用各种治疗(包括新霉素、左旋多巴和换血),仍迅速恶化,终在入院后20～100小时内呼吸停止。尸检均有大量肝细胞坏死和脑水肿,4例证实有脑干疝。鉴于上述发现,后来所见5例肝昏迷4期的暴发性肝炎患者均予脑水肿治疗。此组年龄20～25岁;其中4例HBsAg阳性。入院时凝血酶原时间指数为7～23％。治疗包括:限制液体量、静注大剂量地塞
Patients with fulminant hepatitis complicated with phase IV hepatic coma, despite various treatment measures, have a high case fatality rate. More than 50% of autopsy reportedly have cerebral edema. The authors have seen six cases of hepatic coma in patients with fulminant hepatitis 4, aged 18 to 25 years, of which 4 were HBsAg positive. Prothrombin time index on admission was 18 to 25%. All patients experienced rapid deterioration despite various treatments including neomycin, levodopa and transfusions, and stopped breathing within 20 to 100 hours after admission. Autopsy has a large number of liver cell necrosis and cerebral edema, 4 cases confirmed brain stem hernia. In view of the above findings, then see 5 cases of hepatic coma in patients with fulminant hepatitis 4 are treated with cerebral edema. This group of 20 to 25 years of age; 4 cases of HBsAg-positive. Prothrombin time index on admission was 7 to 23%. Treatment includes: limit the amount of fluid, intravenous bolus large doses