序贯应用血浆置换联合血浆灌流治疗肝衰竭的临床观察  

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

作　　者：范晶华[1] 韦嘉[1] 段志文[1] 张红兵[1] 杨微波[1] 戴虹[1] 

机构地区：[1]昆明医学院第一附属医院感染疾病科,云南昆明650032

出　　处：《昆明医学院学报》2010年第3期75-78,97,共5页Journal of Kunming Medical College

摘　　要：目的探讨序贯应用血浆置换联合血浆灌流的人工肝支持系统治疗模式治疗肝衰竭的疗效和安全性.方法序贯应用血浆置换联合血液灌流治疗80例肝衰竭患者共207例次,选择单纯血浆置换治疗77例患者共200例次作为对照组,分别观察两组治疗前后症状、体征、肝功能、凝血酶原活动度及人工肝支持系统治疗中的不良反应和并发症并追踪近期转归.结果两组人工肝支持系统治疗前后各肝功能指标比较差异有统计学意义(P<0.05),但治疗组及对照组人工肝支持系统治疗后各生化指标比较差异无统计学意义(P>0.05),两组总显效率及病死率比较差异无统计学意义(P>0.05),两组不良反应及并发症比较差异无统计学意义(P>0.05).结论序贯应用血浆置换联合血浆灌流治疗肝衰竭能显著改善患者肝功能,阻止病情恶化,明显提高临床治愈好转率,疗效及并发症与应用单纯血浆置换相当,是辅助治疗肝衰竭的另一安全有效方法.Objective To observe the efficacy and safety of artificial liver support system（ALSS）-plasma exchange and hemoperfusion（PE＋HP） in the treatment of patients with liver failure.Methods 80 patients with liver failure were treated with plasma exchange and hemoperfusion（PE＋HP）.And the other 77 patients with liver failure were treated only with plasma exchange（PE）.Before and after the treatment,the clinical symptoms,signs,adverse effects and complications were observed and the liver function was tested.Results After ALSS,total serumbilirubin,alanine aminotransferase,aspartase aminotransferase and prothrombin time were significantly declined both in these two groups（P 0.05）.There was no significant difference between these two groups in effects,mortality,the side-effects and complications（P 0.05）.Conclusions PE＋PP can effectiveby improve clinical symptoms and liver function and is an effective and safe treatment for patients with liver failure as well as PE.

关 键 词：人工肝支持系统 血浆置换 血浆灌流 肝衰竭 临床观察 

分 类 号：R575.3[医药卫生—消化系统]