单纯血浆置换术治疗肝衰竭30例临床分析  

Treating liver failure with plasma exchange:A clinical analysis of 30 cases

作　　者：涂文辉[1] 侯伟[1] 金茜[1] 邱济海 宋玉龙[1] 张惠娟[1] 

机构地区：[1]浙江省台州市立医院感染科,浙江台州318000

出　　处：《中国现代医生》2012年第35期31-33,共3页China Modern Doctor

摘　　要：目的探讨30例肝衰竭患者经单纯血浆置换术(plasma exchange,PE)治疗后临床转归,评价PE术治疗肝衰竭临床疗效及安全性。方法 PE组30例患者给予常规内科综合治疗基础上联合PE治疗,对照组30例患者给予内科综合治疗,比较PE组和对照组治疗2周的疗效、最终治愈好转率、平均住院日等,并观察PE术的不良反应。结果 PE组30例患者治疗2周临床症状均显著改善,TBIL、ALT、AST、INR下降(P<0.05),PTA升高(P<0.05),而对照组各项指标改善不明显(P>0.05);PE组治愈好转率(24/30)80%,对照组为(15/30)50%,差异有统计学意义(P<0.05),PE组平均住院日34.0 d,对照组44.8 d,两组有统计学差异(P<0.05);总不良反应发生率13.89%,且程度较轻。结论单纯血浆置换术治疗肝衰竭临床疗效及安全性良好,是抢救肝衰竭患者极为重要的治疗手段之一。Objective to probe into the clinical outcome after 30 liver failure patientswere treated with plasma exchange （PE） to evaluate the clinical effect and safety of treatment of liver failure with PE. Methods A total of 30 patients from PE group were treated with the conventional internal medical treatment, combined with PE treatment. And 30 patients from control group were given the internal medical treatment. After 2 weeks of treatment, the treatment effect, the ultimately cure-improve rate and the average length of stay of PE group and control group were compared and the adverse reactions of PE were observed. Results After 2 weeks, the clinical symptoms of 30 patients from PE group were significantly im- proved. TBIL, ALT, AST and INR dropped （P 〈 0.05）, and PTA increased （P 〈 0.05）, while every index from control group was not well improved （P 〉 0.05）. The cure-improve rate is 80%（24/30） for PE group and 50%（15/30） for control group, and there are significant differences statistically in comparison between the two groups （P 〈 0.05）. The average length of stay is 34.0d for PE group and 44.8d for control group, and there are also significant differences statistically （P 〈 0. 05）. The total adverse reaction rate is 13.89%, which is in a slight level. Conclusion Treatment of liver failure with plasma exchange has good clinical effect and safety. It is one of the most important methods to save the liver failure patients.

关 键 词：血浆置换 肝功能衰竭 

分 类 号：R969.4[医药卫生—药理学]