胆红素吸附联合血浆置换对治疗肝衰竭近期疗效影响的相关性研究  

Evaluation of the recent therapeutic efficacy of bilirubin adsorption combined with plasma exchange on liver failure

作　　者：朱其荣[1] 王川林[1] 刘娇[1] 古雪[1] 李铃[1] 孙辉[1] ZHU Qi-rong;WANG Chuan-lin;LIU Jiao;GU Xue;LI Ling;SUN Hui(Department of Infectious Diseases , Affiliated Hospital of North Sichuan Medical College ,Nanchong 631000 , Sichuan, China)

机构地区：[1]川北医学院附属医院感染科,四川南充637000

出　　处：《川北医学院学报》2017年第4期587-590,共4页Journal of North Sichuan Medical College

摘　　要：目的:探究胆红素吸附联合血浆置换对治疗肝衰竭患者近期临床疗效的影响效果。方法:收集85例肝衰竭患者的临床资料,在防止肝细胞坏死、促进肝细胞再生的综合治疗基础上,根据人工肝治疗模式的不同分为观察组和对照组,观察组42例患者行胆红素吸附联合血浆置换治疗;对照组43例患者行单纯血浆置换治疗。比较两组患者治疗前后及两组之间谷丙转氨酶(ALT)、总胆红素(TBIL)、凝血酶原时间(PT)、谷草转氨酶(AST)的变化以及人工肝治疗过程中的不良反应。结果:经过胆红素吸附联合血浆置换后,观察组与对照组的好转率分别为85.7%(36/42)、88.4%(38/43),两组比较差异无统计学意义(P>0.05);两组患者血清主要生化指标中ALT、AST、TBIL较治疗前下降明显,二者比较差异有统计学意义(P<0.01);PT较治疗前下降明显,二者比较差异有统计学意义(P<0.05)。观察组治疗前后血清ALT、PT、TBIL、AST值与对照组治疗前后血清ALT、PT、TBIL、AST值对应性比较,二者差异无统计学意义(P>0.05)。观察组患者接受胆红素吸附联合血浆置换共103例次,最少1例次,最多5例次,人均2.45次,发生不良反应36例次(34.95%);对照组43例患者接受单纯血浆置换共99例次,最少1例次,最多4例次,人均2.3次,发生不良反应25例次(25.3%)。结论:胆红素吸附联合血浆置换能有效改善肝衰竭患者的肝功能,与单纯血浆置换比较,能减少血浆的用量,减少输血传播疾病的风险。Objective:To explore the recent clinical curative effects of bilirubin adsorption combined with plasma exchange in the treatment of patients with liver failure.Methods:A total of85hospitalized patients with liver failure were enrolled in our depart-ment.On the basis of comprehensive treatment in preventing liver cell necrosis and promoting hepatocyte regeneration,patients were di-vided into the observation group and the control group according to the different modes of artificial liver treatment.42cases of patients in observation group were treated with bilirubin adsorption combined with plasma exchange,and43cases of patients in control group were treated with simple plasma exchange.The changes of alanine transaminase(ALT),total bilirubin(TBIL),prothrombin time(PT),aspertate aminotransferase(AST)before and after treatment in two groups were compared,and the changes of all of those index were also compared between the two groups.The adverse reactions were observed in the process of artificial liver treatment.Results:Af-ter the bilirubin adsorption combined with plasma exchange,the improvement rate of observation group and control group was85.7%(36/42),88.4%(38/43)respectively.There was no significant difference between the two groups(P>0.05);the major biochemical indexes of serum ALT,AST,TBIL were decreased significantly compared with those before treatment(P<0.01).Prothrombin time of the two groups was shorter significantly(P<0.01)after artificial liver treatment.Before and after artificial liver treatment,the differ-ences of serum ALT,PT,TBIL,AST were not significant between the two groups.The observation group patients received a total of103cases of bilirubin adsorption joint plasma exchange,at least1case,up to5cases,2.45times per capita.36(34.95%)cases of adverse reactions occurred in the observation group.In the control group,43patients were received a total of99cases of simple plasma ex-change,at least1case,up to4cases,2.3times per capita.25(25.3%)cases of adverse reactions occurred in the control group.Cone

关 键 词：肝衰竭 胆红素吸附 血浆置换 不良反应 疗效 

分 类 号：R575.3[医药卫生—消化系统]