三种人工肝疗法对重型肝炎患者电解质的影响  

The effect of three artificial liver supports on serum electrolytes in severe hepatitis

作　　者：王宝华[1] 宋树芬[1] 代学琴[1] 高晓卡 

机构地区：[1]青岛市传染病医院血液净化中心,266033

出　　处：《肝脏》2005年第2期100-102,共3页Chinese Hepatology

摘　　要：目的观察和比较血浆置换(PE)、血浆吸附(PA)、血液灌流联合血液透析(HP+HD)不同人工肝支持系统(ALSS)治疗前后重型肝炎患者血电解质的变化,并分析原因以减少不良反应。方法68例重型肝炎患者分别行PE、PA、HP+HD治疗共135次,在每次治疗前后取血测K+、Na+、Cl-、HCO-3、Ca2+,比较它们在ALSS治疗前后的变化。结果68例患者行人工肝治疗后症状及肝功能均明显改善,比较每次治疗后与治疗前结果显示,PE组Ca2+下降(P<0.01),Na+和HCO-3升高(P均<0.05);HP+HD组K+下降(P<0.05),其余电解质变化不明显(P>0.05)。结论不同人工肝疗法引起血电解质的变化不同,以上不良反应可通过相应措施预防或减轻,以保持内环境的稳定。Objective To investigate changes of electrolyte in the serum of severe hepatitis after treatment of artificial liver support system(SLSS), including plasma exchange(PE), plasma absorption(PA) and hemoperfusion combined with hemodialysis (HP+HD), the causes and side effects. Methods Sixty-eight patients were treated with PE、PA、HP+HD for 135 times. The serum levels of electrolyte including K +、Na +、Cl -、HCO - 3、Ca 2+ were measured and compared.Results Patients undergoing ALSS showed significant improvements in clinical symptoms. After treatment, the serum level of Ca 2+ reduced(P< 0.01 ), Na + and HCO - 3 increased(P< 0.05 ) in PE group; the serum level of K + reduced (P< 0.05 ) in HP+HD group and the others parameters didn't change significantly(P> 0.05 ). Conclusion Different artificial liver treatments can cause the different changes in the serum levels of electrolytes. The preventive measures can be used correspondingly to decrease the adverse effects and keep balance of internal environment.

关 键 词：人工肝疗法 重型肝炎 电解质 血浆置换 血浆吸附 血液灌流 血液透析 

分 类 号：R575.1[医药卫生—消化系统] R318.14[医药卫生—内科学]