少量血浆进行人工肝治疗慢加急性肝衰竭的探讨  

Extracorporeal Liver Support with Less Fresh Frozen Plasma for Treatment of Acute-on-chronic Liver Failure

作　　者：章莉莎[1] 赵满芝[1] 许东[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院感染科,武汉430030

出　　处：《华中科技大学学报（医学版）》2015年第1期87-91,共5页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

基　　金：湖北省自然科学基金资助项目(No.2013CFB077)

摘　　要：目的观察应用少量血浆进行人工肝治疗慢加急性肝衰竭的疗效。方法回顾性分析45例住院治疗的慢加急性肝衰竭患者,分为观察组(少量血浆PP+PE组)、对照组1(PE组)、对照组2(PP+PE组)(PP为血浆吸附,PE为血浆置换),共接受人工肝治疗62次。结果 3组患者治疗后与治疗前比较,临床症状均有所改善。3组间相比较,在降低谷丙转氨酶(ALT)、谷草转氨酶(AST)、直接胆红素(DBil)这3个指标上差异有统计学意义,对于总胆红素(TBil)的改善和降低血氨等方面无明显差异。在其余肝、肾功能各项指标上3组间差异无统计学意义。与对照组1和对照组2相比,观察组在改善凝血功能方面效果较差,差异有统计学意义。结论在目前血浆紧张的情况下,可以应用血浆吸附联合少量新鲜冰冻血浆进行人工肝治疗,能有效降低胆红素,缓解临床症状,减少并发症的发生。Objective To observe the efficacy of extracorporeal liver support by using less fresh frozen plasma in the treat‐ment of acute‐on‐chronic liver failure.Methods A total of 45 patients with acute‐on‐chronic liver failure were divided into ob‐servation group[plasma perfusion（PP） with a small amount of plasma＋ plasma exchange（PE）] ,control group 1（PE） ,control group 2（PP＋PE）in terms of the amount of plasma used on the day of treatment. All the patients received artificial liver treatnts 62 times totally.Results The clinical symptoms were improved in the three groups after treatments.There were significant differences in the decrease of alanine transaminase （ALT） ,aspartate transaminase（AST） and direct bilirubin（DBil）rather than the decrease of total bilirubin（TBil）and blood ammonia among the groups.No significant difference was noted in the liver and kidney function among the three groups. The improvement of the coagulation function was poor in the observation group when compared with the control group 1 and control group 2 and there were significant differences.Conclusion During the short sup‐ply of the plasma ,plasma perfusion combined with small amount of plasma can be considered to be used in artificial liver treat‐ments ,which can effectively decrease the level of TBil ,relieve symptoms and decrease the occurrence of complications.

关 键 词：少量血浆 人工肝支持系统 慢加急性肝衰竭 

分 类 号：R575.3[医药卫生—消化系统]