两种人工肝支持系统治疗70例重症肝衰竭患者的安全性及有效性的比较  

Comparison of efficacy and safety between two artificial liver supporting systems in the treatment of 70 cases with severe hepatic failure

作　　者：陈舜杰[1] 陆玮[1] 季刚[1] 单剑萍[1] 朱淳[1] 蒋更如[1] 

机构地区：[1]上海交通大学医学院附属新华医院肾脏科,上海200092

出　　处：《中国血液净化》2009年第1期49-52,共4页Chinese Journal of Blood Purification

摘　　要：目的比较血浆置换(PE)联合连续性静脉-静脉血液透析滤过(CVVHDF),血液灌流(HP)联合CVVHDF在人工肝支持治疗中的有效性和安全性。方法对70例重症肝衰竭患者分为两组,分别给予单次PE联合CVVHDF或单次HP联合CVVHDF的人工肝支持治疗,观察患者临床症状的变化,比较治疗前后电解质、肝肾功能、凝血酶原时间(PT)、部分凝血活酶时间(APTT)的变化。结果经过上述两种模式治疗后,两组患者的临床症状均有不同程度改善,血清总胆红素(TB)、血清肌酐(Scr)、血清尿素氮(BUN)、谷丙转氨酶(AST)、谷草转氨酶(ALT)均明显下降(P<0.01);电解质恢复正常(P<0.01)。与HP联合CVVHDF治疗组相比,PE联合CVVHDF组治疗结束时PT、APTT均明显下降(P<0.01),血清白蛋白(Alb)明显升高(P<0.01)。二种模式治疗的不良反应均较轻。结论两种治疗模式均能有效清除肝衰竭或者合并肾衰竭产生的各种有毒物质。两种治疗模式均能调节水电解质平衡。PE联合CVVHDF治疗后,患者血清白蛋白浓度明显提高,出凝血功能明显改善,优于HP联合CVVHDF治疗组。Objective Non-bioartificial liver has been applied in clinical practice,but the efficacy was re-ported to be quite different. The aim of this study was to compare the efficacy and safety of plasma exchange (PE) plus continuous venovenous hemodiafiltration (CVVHDF) and hemoperfusion adsorption (HP) plus CVVHDF in the treatment of severe viral hepatitis. Methods Seventy patients with severe liver hepatitis were randomly divided into two groups: patients with single treatment of PE+CVVHDF (36 cases) and those ...

关 键 词：血浆置换 血液灌流 肝功能衰竭 人工肝 连续性静脉-静脉血液透析滤过 

分 类 号：R575.3[医药卫生—消化系统]