血浆置换对治疗肝功能衰竭的疗效观察  

Clinical Observation of Plasma Exchange in the Treatment of Patients with Liver Failure

作　　者：李武[1] 段志文[1] 张红兵[1] 韦嘉[1] 杨微波[1] 牛英[1] 

机构地区：[1]昆明医学院第一附属医院感染科,云南昆明650032

出　　处：《昆明医学院学报》2008年第1期138-141,共4页Journal of Kunming Medical College

摘　　要：目的探讨血浆置换对治疗肝功能衰竭的临床疗效及安全性.方法将52例肝功能衰竭病人随机分为两组:PE治疗组和对照组各26例,PE治疗组在常规内科综合治疗基础上进行血浆置换,对照组给予常规内科综合治疗.比较治疗前后的临床表现、肝功能、凝血酶原活动度、血氨的变化和有效率.结果PE治疗组临床症状改善率(84.6%)明显优于对照组(53.85%),P<0.05.PE治疗组治疗后TBIL、PTA及ALT的改善均显著优于对照组(P<0.05).PE治疗组有效率76.92%,显著高于对照组(46.15%).PE治疗组早、中期有效率(87.5%、88.89%)明显高于晚期肝衰竭(57.14%),P<0.05.PE常见不良反应为血浆过敏,未见严重不良反应.结论血浆置换PE可显著改善肝功能衰竭患者的临床症状及血生化指标,且安全可行,为肝细胞的再生赢得宝贵的时间,可以作为临床治疗早、中期肝功能衰竭的有效措施之一,且可以为晚期患者行肝脏移植赢得时间.Objective To observe the efficacy and safety of artificial liver support system - plasma exchange （PE） in treatment of patients with liver failure.Methods 52 Patients with liver failure were randomly divided into treatment group （n =26） and control group（n=26）.Conventional liver-protecting therapy was given to all patients in two groups. Additionally, plasma exchange was given to the treatment group simultaneously. Before and after treatment, the clinical symptom, liver function tests, prothrombin activity and changes and effective rates of blood ammonia were examined. Results The rate of clinical symptom improvement in PE treatment group （84.6%） was significantly higher than that in control group （53.85%） （P 〈 0.05）. After plasma exchange, total serum bilirubin, alanine aminotransferase, aspartase aminotransferase and prothrombin time significantly declined. The improvements of TBIL, PTA and ALT in PE treatment group were significantly better than those in control group （P〈 0.05）. The effective rate in PE treatment group was 76.92%, much higher than that （46.15%） in control group （P 〈 0.05）. The efficacy of early stage and middle stage are both higher than those of late stage in PE treatment group（87.5% and 88.89% vs 57.14%） （P 〈 0.05）. The most common side effects of PE treatment was plasma allergy but no severe complications were found. Conclusions PE can effectively alleviate clinical symptoms, improve liver function and is an effective and safe treatment for patients with liver failure during early to middle stage, and can win time for the patients of later period waiting for liver transplantations.

关 键 词：肝衰竭 血浆置换 疗效 

分 类 号：R51[医药卫生—内科学]