血浆吸附治疗在肝衰竭伴高胆红素血症中的应用  

Application Value of Plasma Adsorption in Hepatic Failure Complicated with Hyperbilirubinemia

作　　者：诸伟花 孟宇[2] Zhu Weihua;Meng Yu(Blood Purification Room,Heyuan People s Hospital,Heyuan 517000 China;Nephrology Department,Overseas Chinese Hospital of Jinan University,Guangzhou 510630 China)

机构地区：[1]河源市人民医院血液净化室,广东河源517000 [2]暨南大学华侨医院肾内科,广东广州510630

出　　处：《锦州医科大学学报》2020年第1期59-61,共3页Journal of Jinzhou Medical University

基　　金：河源市社会发展科学技术项目，项目编号:河科2016-56-27

摘　　要：目的探究重症肝炎肝衰竭并高胆红素血症行血浆吸附的疗效。方法选取我院2014年1月至2018年12月收治的60例重症肝炎肝衰竭并高胆红素血症患者作为研究对象,按数字随机表法分为对照组30例和实验组30例。对照组采用常规血浆置换治疗,观察组在对照组的基础上行血浆吸附治疗,比较两组临床疗效和血清总胆红素(TBIL)、直接胆红素(DBIL)、谷酰转肽酶(ALT)、凝血酶原活动度(PTA)等肝功能指标。结果对照组临床治疗总有效率为73.33%(22/30),实验组临床治疗总有效率为93.33%(28/30),实验组高于对照组,差异有统计学意义(P<0.05)。治疗前,对照组和实验组TBIL,DBIL,ALT,PTA差异无统计学意义(P>0.05);治疗后,两组TBIL,DBIL,ALT,PTA均较治疗前明显改善,差异有统计学意义(P<0.05);实验组治疗后TBIL,DBIL,ALT均低于对照组,PTA高于对照组,差异有统计学意义(P<0.05)。结论重症肝炎肝衰竭合并高胆红素血症,采取血浆吸附治疗的方式效果明显,可降低血清胆红素水平,改善患者肝功能,值得推广。Objective To investigate the effect of plasma adsorption on severe hepatitis and hepatic failure complicated with hyperbilirubinemia.Methods 60 patients with severe hepatitis and hepatic failure with hyperbilirubinemia admitted to our hospital from January 2014 to December 2018 were selected as the study subjects and randomly divided into control group(30 cases)and experimental group(30 cases)The control group was treated with routine plasma exchange,and the observation group was given plasma adsorption on the basis of the treatment for the control group The clinical efficacy and liver function indices,such as serum total bilirubin(TBIL),direct bilirubin(DBIL),glutamyl transpeptidase(ALT)and prothrombin activity(PTA)of the two groups were compared.Results The total clinical effective rate of the control group was 73.33%(22/30),higher than that of the experimental group which was 93.33%(28/30),and the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in TBIL,DBIL,ALT and PTA between the control group and the experimental group(P>0.05).After treatment,TBIL,DBIL,ALT and PTA in the two groups were significantly improved compared with those before treatment,and the difference was statistically significant(P<0.05).After treatment,TBIL,DBIL and ALT in the experimental group were all lower than those in the control group,and PTA of the control group was significantly higher than that of the control group,with statistically significant difference(P<0.05).Conclusion Plasma adsorption is effective in the treatment of severe hepatitis and hepatic failure combined with hyperbilirubinemia which can reduce the level of serum bilirubin and improve the liver function of patients,which is worth popularizing.

关 键 词：肝衰竭 高胆红素血症 血浆置换 血浆吸附 效果 

分 类 号：R575.3[医药卫生—消化系统]