两种血浆分离器在肝衰竭患者血浆置换治疗中的疗效比较  

Comparison of the efficacy of two plasma separators in the treatment of plasma exchange in patients with liver failure

作　　者：何作萍 罗佩芳 杨斌[1] HE Zuoping;LUO Peifang;YANG Bin(Department of Blood Transfusion,the Fifth Affiliated Hospital of Sun Yatsen University,Zhuhai 519000,China;Department of Blood Transfusion,the Sixth,Affiliated,Hospital of Guangzhou Medical University,Qingyuan People's Hospital)

机构地区：[1]中山大学附属第五医院输血科,广东珠海519000 [2]广州医科大学附属第六医院清远市人民医院输血科

出　　处：《中国输血杂志》2020年第1期66-69,共4页Chinese Journal of Blood Transfusion

摘　　要：目的对比Bellco MICROPLAS MPS 05和AsahiKASEI OP-05W两种血浆分离器进行血浆置换治疗肝衰竭的有效性和安全性。方法收集2015-2018年在中山大学附属第五医院住院治疗的肝衰竭患者145名,分为3组。对照组47名患者,采取内科基础综合治疗;实验组1共53名患者,由血透室使用Bellco MICROPLAS MPS 05血浆分离器进行治疗;实验组2共45名患者,由感染科使用AsahiKASEI OP-05W血浆分离器进行治疗。评估对患者的治疗效果。结果 12个实验组治疗后患者ALT,AST,TBiL,DBiL水平均较治疗前显著降低,PTA显著升高(P<0.05);实验组2较实验组1治疗后患者TBiL,DBiL水平显著降低,PTA显著升高(P<0.05);实验组1治疗有效率(49.60%,26/53)显著低于实验组2(80.00%,36/45)(P<0.05);32组实验组血浆置换治疗过程中均未出现不良反应。结论结果显示,血浆置换能有效改善肝衰竭患者肝功能,且未发生不良反应。且感染科采用AsahiKASEI OP-05W血浆分离器开展的血浆置换治疗效果优于血透室采用Bellco MICROPLAS MPS 05血浆分离器的治疗效果。Objective To compare the safety and efficacy of two plasma separators, ie Bellco MICROPLAS MPS 05 and AsahiKASEI OP-05 W, in the treatment of plasma exchange(PE) in patients with liver failure. Methods 145 hepatic failure patients enrolled in the Fifth Affiliated Hospital of Sun Yat-sen University from January, 2015 to December, 2018 were divided into 3 groups. The control group contained 47 patients who only received basic medical treatment. Treatment group 1 contained 53 patients who treated by 2 000-2 500 mL of PE(using inactivated fresh frozen plasma) via plasma separator named Bellco MICROPLAS MPS 05 in the hemodialysis room. Treatment group 2 contained 45 patients treated by PE via plasma separator named AsahiKASEI OP-05 W in the Department of Infectious Disease. The clinical and biochemical parameters of liver failure patients after PE treatment were recorded. Results When compared with baseline, the levels of ALT, AST, TBiL, and DBiL decreased significantly in both of the treatment groups after PE,while PTA increased significantly(P<0.05). The decrease of TBiL and DBiL, as well as the increase of PTA after PE in Treatment group 2 showed significant difference compared to that of Treatment group 2(P<0.05). The curative rate of treatment group 1(49.6%) was obviously lower than that of group 2(80.00%)(P<0.05). No adverse effect of PE was observed in any of the patients during or after completion of PE. Conclusion Plasma exchange therapy can effectively improve liver function of hepatic failure patients without any adverse reactions. The curative effect of AsahiKASEI OP-05 W used in the Department of Infectious Diseases is superior comparable to Bellco MICROPLAS MPS 05 used in the hemodialysis room.

关 键 词：肝衰竭 血浆置换 肝功能 凝血功能 临床治疗效果 

分 类 号：R457.14[医药卫生—治疗学] R575.3[医药卫生—临床医学]