469例肝衰竭患者人工肝治疗前后疗效分析  

Retrospective analysis of efficacy of artificial liver support system in 469 patients with live failure

作　　者：唐黎[1] 陈文[1] 邓存良[1] 任东东[1] 胡小超[1] 张超[1] 王文龙[1] 宋颖[1] 盛云建[1] 吴刚[1] 

机构地区：[1]泸州医学院附属医院,四川泸州646000

出　　处：《西部医学》2014年第1期34-36,共3页Medical Journal of West China

基　　金：国家科技部"十一五"重大专项课题(2009ZX10005-020)

摘　　要：目的分析人工肝治疗肝衰竭患者前后指标的差异及单用血浆置换与血浆置换联合血浆灌流的疗效差异。方法 469例肝衰竭患者,共889例次人工肝治疗,治疗前后采集患者血液查肝功能、肾功能、电解质、血常规、凝血功能,结果采用SPSS 19.0统计分析。结果人工肝治疗后,ALT、AST、TBIL、GGT、BUN、Cr、K+、WBC、Hb、PLT、PT、INR均下降;ALB、Na+、PTA、中性粒细胞率均上升。单用血浆置换与血浆置换联合血浆灌流相比,治疗前后血AST、ALB、GGT、TBIL、PTA、Na+、K+、WBC、Hb水平的改变程度有差异。结论人工肝治疗能改善患者肝功能、凝血功能,但可导致血钠上升、血钾下降、血小板计数及血红蛋白下降、中性粒细胞率显著上升。单用血浆置换在改善肝功能、凝血功能方面疗效优于血浆置换联合血浆灌流;联用与单用相比,更不容易造成血钠上升和血钾、血红蛋白的下降。血浆置换联用血浆灌流在较少的血浆消耗的情况下,仍有较好的疗效。Objective To retrospectively analyze the efficacy of ALSS in patients with liver failure and the differ- ences of curative effect between plasma exchange alone （PE） and plasma exchange combine with plasma perfusion （PEW PP） . Methods A total of 469 patients with liver failure were treated with ALSS for 889 times. Collect patienfs blood be- fore and after ALSS treatment for blood routine, electrolytes, coagulation function, hepatic and renal function examina- tion. Data was analyzed with SPSS 19.0. Results After ALSS treatment, the level of ALT, AST, TBIL, GGT, BUN, Cr, K＋ ,WBC, Hb, PLT, PT and INR were decreased~ the level of ALB, Naq-, PTA and the percentage of neutrophils were increased. There are significant difference between PE and PEq-PP in the change of the level of AST, ALB, GGT, TBIL, PTA, Na＋ , K＋ , WBC and Hb. Conclusion ALSS is effective to improve the hepatic function and coagulation function in patients with liver failure, but result in the level of blood Nal- increasing and the level of blood K＋ , ALB, percentage of neutrophils decreasing. PE is more effective than PE＋PP in improving hepatic function and coagulation function, but PE is more likely to result in the level of blood Naq- increasing and the level of blood K＋-, ALB decrea- sing. Although PE＋PP cost less fresh frozen plasma than PE, the efficacy of PE＋PP is still satisfactory.

关 键 词：血浆置换 血浆灌流 肝衰竭 人工肝 

分 类 号：R575.3[医药卫生—消化系统]