目的　探讨应用血浆置换 (PE)治疗重型肝炎的疗效和治疗时机。方法　设观察组和对照组 ,两组在护肝综合治疗的基础上 ,观察组同时给予PE治疗。观察不同病期治愈好转率、总有效率 ,平均住院天数和主要实验室检查指标。结果　观察组 (76例 )重型肝炎早、中、晚期治愈好转率分别为 99.97% ,79.17% ,2 6 .32 % ,总有效率73.6 8% ;对照组 (4 5例 )分别为 6 5 % ,5 7.14 % ,9.0 9% ,总有效率 4 8.89% ;临床治愈病例平均住院时间 ,观察组为2 2 .5 2± 13.5 6d ,对照组为 5 2 .4 4± 18.2 5d ,两组比较 ,差异有显著性 (P <0 .0 0 1)。结论　PE是治疗重型肝炎较为安全有效的方法 ,重型肝炎患者宜在早、中期即用血浆置换治疗。 Objective To investigate the curative effect and timing of the treatment of severe hepatitis by plasma exchange (PE). Methods The observation group and the control group were set up, and the two groups were treated with PE on the basis of comprehensive treatment of liver. Observe the healing rate of different stages of disease, the total effective rate, the average number of days of hospitalization and the main laboratory test indicators. Results The improvement rate of early, middle and late treatment of severe hepatitis in the observation group (76 cases) were 99.97%, 79.17%, 22.6%, 73.68%, respectively; the control group (45 cases) , 5 7.14% and 9.0 9%, respectively, and the total effective rate was 4 8.89%. The average length of stay in clinically cured cases was 22.52 ± 13.56 days in the observation group and 52.44 ± 18.2 days in the control group , The difference was significant (P <0. 001). Conclusions PE is a safe and effective treatment for severe hepatitis. Patients with severe hepatitis should be treated with plasma exchange in the early and middle stages.