血浆置换联合血浆灌流治疗急性肝衰竭的临床疗效分析  

The clinical efficacy analysis of plasma exchange combined with plasma perfusion in treatment of acute liver failure

作　　者：王盖昊 刘凯辉[1] 张潇艺[1] 翟卫春[1] 惠玲[2] 于晓辉[1] 

机构地区：[1]兰州军区兰州总医院消化科,甘肃兰州730050 [2]兰州军区兰州总医院医学实验中心、甘肃省干细胞与基因药物重点实验室

出　　处：《胃肠病学和肝病学杂志》2017年第11期1294-1297,共4页Chinese Journal of Gastroenterology and Hepatology

基　　金：甘肃省科技支撑计划项目(1604FKCA101)

摘　　要：目的研究分析血浆置换(plasma exchange,PE)联合血浆灌流(plasma perfusion,PP)治疗急性肝衰竭(acute liver failure,ALF)患者治疗前后的疗效。方法 31例ALF患者共行治疗95例次,分析治疗前与治疗结束后患者临床症状、白细胞计数、肝功能、凝血功能及血氨主要指标变化,同时观察治疗过程中及治疗后24 h内不良反应及最后治疗效果。结果 ALF患者治疗后丙氨酸氨基转氨酶(ALT)、天门冬氨酸氨基转移酶(AST)、白蛋白(ALB)、总胆红素(TBIL)、白细胞计数(WBC)和血氨均较治疗前显著下降(P<0.01);凝血酶原时间活动度(PTA)较治疗前显著改善(P<0.01);PE联合PP治疗ALF总有效率为61.3%(19/31),不良反应发生率为23.1%(22/95)。结论 PE联合PP可显著改善ALF患者临床症状,且不良反应少,是治疗ALF安全、有效的一种联合方式。Objective To investigate the effect of plasma exchange （PE） combined with plasma perfusion （PP） on acute liver failure （ALF） before and after the treatment. Methods Thirty-one patients with ALF were treated in 95 cases. The clinical symptoms, white blood cell count, liver function, blood coagulation function and the main indexes of plasma ammonia were analyzed before and after treatment. Meanwhile, the adverse reactions and final treatment effects were ob- served during the course of treatment and after 24 hours treatment. Results ALT, AST, ALB, TBIL, WBC and blood ammonia in patients with ALF were significantly lower than before treatment （P 〈 0.01 ）. Prothrombin time activity （PTA） was significantly improved compared with before treatment （P 〈0.01 ）. The total effective rate of PE combined with PP for ALF was 61.3% （ 19/31 ） , and the incidence of adverse reactions was 23.1% （22/95）. Conclusion PE combined with PP can significantly improve the clinical symptoms of ALF patients, and fewer adverse reactions, the treatment of ALF is a safe and effective way.

关 键 词：血浆置换 血浆灌流 急性肝衰竭 临床疗效 

分 类 号：R575.3[医药卫生—消化系统]