输血后丙型肝炎60例临床分析(1)
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[摘要] 目的：探讨输血后丙型肝炎患者疾病转归及治疗效果。方法：选择本院2001年1月～2009年12月收治的输血后丙型肝炎患者60例，分析其病情进展及临床治疗效果。结果：所有患者均诊断为输血后慢性丙型肝炎，至入院时已发展为肝硬化18例，发展为肝癌12例；入院时即有肝硬化者18例，治疗好转率为11.11%，入院时未出现肝硬化者42例，治疗好转率为54.76%，未合并肝硬化者治疗有效率高于已合并肝硬化者，差异具有统计学意义(χ2＝5.37，P<0.05)。60例患者治疗有效率为41.67%。结论：血液采集前需严格检查，严格掌握输血适应证，预防输血导致丙型肝炎病毒的感染，患者感染丙型肝炎病毒后，需常规进行保肝、抗纤维化治疗，以延缓病情进展，提高患者生存质量。
[关键词] 输血；丙型肝炎病毒；血液传播；肝硬化；原发性肝癌
[中图分类号] R512.6+3[文献标识码] B[文章编号] 1673-7210(2011)07(b)-068-02
Clinical analysis of 60 cases of post-transfusion hepatitis C
WANG Laisheng
The Third Hospital of Xiangtan City in Hunan Province, Xiangtan 411102, China
[Abstract] Objective: To discuss the disease development and the clinical effect of the post-transfusion hepatitis C. Methods: 60 cases of post-transfusion hepatitis C were selected, and their disease development and the clinical effect were analyzed. Results: All the 60 cases were diagnosed post-transfusion chronic hepatitis C, when they came to our hospital, 18 cases of them were diagnosed liver cirrhosis, 12 cases of them were diagnosed primary liver cancer. The improvement rate of the patients with liver cirrhosis was 11.11%, the improvement rate of the patients without liver cirrhosis was 54.76%, showed significant difference (χ2＝5.37, P<0.05). The improvement rate of the 60 cases was 41.67%. Conclusion: The blood should be strictly checked before it will be inputed into the patients, and indications should be abided strictly, conventional liver protecting treatment should be done to the patients with HCV.
[Key words] Blood transfusion; HCV; Blood transmission; Liver cirrhosis; Primary liver cancer
丙型肝炎病毒(HCV)的主要传播途径是经血液传播[1]，未广泛开展丙型病毒性肝炎筛查的时期是HCV感染的高发期，几十年前，曾经将输血指征放宽，导致了HCV的大量传播[2]，HCV感染后易引起肝脏的慢性病变，且目前临床上治疗无特别有效手段，故重点应放在对其预防上。我院近年来收治输血后丙型肝炎患者60例，现将其临床资料进行分析，报道如下：
1 资料与方法
1.1 一般资料
我院2001年1月～2009年12月收治输血后丙型肝炎患者60例，其中男23例，女37例；患者年龄37～72岁，平均(53.0±11.3)岁；病程11～36年，平均(23.7±6.3)年。患者乏力36例，食欲差27例，伴恶心、呕吐19例，发热3例，黄疸24例，无明显症状者7例；合并高血压16例，糖尿病13例，无结核病史，无药物过敏史。
1.2 输血原因
产后出血21例，外伤后失血19例，外科手术后11例，贫血9例。受血次数1～7次，受血量400～2 800 ml。输血过程中未出现输血反应。
1.3 诊断标准
①发病前有输血史；②输血前无肝炎，输血后2周至半年内具有肝炎临床表现，查肝功能异常；③实验室检查排除甲型、丁型、戊型肝炎，乙型肝炎指标输血前后无变化；④实验室检查抗-HCV阳性 ......
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