输注血浆联合连续性血液净化治疗急性肝功能衰竭40例疗效观察  

Effect intravenous infusion of plasma combined continuous vein-vein hemofiltration in the treatment of acute liver failure

作　　者：马英杰 

机构地区：[1]成武县人民医院消化内科,山东成武274200

出　　处：《临床消化病杂志》2017年第2期106-108,共3页Chinese Journal of Clinical Gastroenterology

摘　　要：[目的]探讨输注血浆联合连续性静-静脉血液滤过(CVVH)治疗急性肝功能衰竭的疗效、安全性及可行性。[方法]对40例急性肝功能衰竭患者应用输注血浆联合CVVH治疗,通过比较治疗前后患者临床症状、血清总胆红素(TBIL)、白蛋白(ALB)、凝血酶原活动度(PTA)等指标判断临床疗效,观察治疗相关的不良反应及患者耐受情况,判断安全性及可行性。[结果]治疗后患者意识模糊、乏力、纳差、腹胀、黄疸等症状均明显缓解,血清TBIL较治疗前降低,ALB、PTA上升,治疗后近期有效率达70%,不良反应少,未发生大出血、休克等严重并发症,患者耐受良好。[结论]在内科综合治疗的基础上输注血浆联合CVVH治疗可显著改善急性肝功能衰竭患者临床症状及肝功能生化指标,提高近期存活率,且安全可行,具有较高的临床应用价值。[Objective]To investigate the efficacy,safety and feasibility of intravenous infusion of plasma combined continuous vein-vein hemofiltration（CVVH）on the treatment of acute liver failure（ALF）.[Methods]Forty cases of ALF patients were treated with infusion of plasma combined with CVVH treatment.The clinical efficacy was observed by comparing the clinical symptoms,serum total bilirubin（TBIL）,albumin（ALB）,prothrombin activity（PTA）and other indicators.The safety and feasibility were investigated by evaluating the adverse reactions during the treatment.[Results]The symptoms including confusion,fatigue,anorexia,abdominal distension,jaundice were alleviated,the serum total bilirubin decreased,ALB and PTA increased after the treatment when comparing to those before treatment.The short-term effective rate was 70 %.No adverse reaction,including the gastrointestinal bleeding,shock and other serious complications occurred.All patients tolerated the treatment well.[Conclusion]Combined treatment of CVVH in the department of internal medicine can improve the clinical symptoms and liver function in patients with ALF and improve the short-term survival rate,and it is safe and feasible,which has high clinical application value.

关 键 词：急性肝功能衰竭 连续性静-静脉血液滤过 静脉输注血浆 

分 类 号：R575.3[医药卫生—消化系统]