三种模式非生物型人工肝对急性肝衰竭患者肝功能、凝血功能及生存率的影响  

Effects of three modes of artificial liver therapy on liver function,coagulation function and survival rate in patients with acute liver failure

作　　者：李剀 杨晓莉[2] 杨道坤[3] Li Kai;Yang Xiaoli;Yang Daokun(Department of Infection,Shangqiu Municipal Hospital,Shangqiu 476100,China;School of Clinical Medicine,Shangqiu Medical College,Shangqiu 476100,China;Department of Infection,the First Affiliated Hospital of Xinxiang Medical College,Xinxiang 453100,China)

机构地区：[1]河南省商丘市立医院感染科,476100 [2]商丘医学高等专科学校临床医学院,476100 [3]新乡医学院第一附属医院感染科,453100

出　　处：《中国实用医刊》2020年第16期55-58,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨三种模式非生物型人工肝对急性肝衰竭患者肝功能、凝血功能及生存率的影响。方法抽取2018年3月至2020年1月商丘市立医院感染科收治的85例急性肝衰竭患者进行研究,根据治疗方法不同分为A组(血浆灌流模式)25例、B组(血浆透析滤过模式)34例、C组(血浆灌注模式联合血液透析滤过模式)26例。治疗6个月后,观察两组肝功能、凝血功能及生存率。结果治疗后,三组总胆红素(TBIL)、丙氨酸氨基转移酶(ALT)低于治疗前,白蛋白(ALB)、凝血酶原活动度(PTA)高于治疗前,差异有统计学意义(P<0.05);但各组间TBIL、ALT、ALB、PTA比较差异未见统计学意义(P>0.05)。C组凝血酶原时间(PT)高于A组和B组,活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(Fib)低于A组和B组,差异有统计学意义(P<0.05)。治疗3、6个月后,A、B、C组三组生存率比较,差异未见统计学意义(P>0.05)。结论血浆灌注模式、血液透析滤过模式及联合治疗均能够改善急性肝衰竭肝功能、凝血功能,提高生存率。Objective To explore the effects of three models of artificial liver therapy on liver function,coagulation function and survival rate in patients with acute liver failure.Methods Eighty-five patients with acute liver failure admitted to the Department of Infectious Diseases in Shangqiu Municipal Hospital from March 2018 to January 2020 were enrolled,According to different treatment methods,they were divided into group A(n=25,plasma perfusion mode),group B(n=34,hemodiafiltration mode),and group C(n=26,plasma perfusion mode combined with hemodiafiltration mode).After 6 months of treatment,the liver function,coagulation function and survival rate of the two groups were observed.Results After treatment,total bilirubin(TBIL)and alanine aminotransferase(ALT)in the three groups were lower than before treatment,while albumin(ALB)and prothrombin activity(PTA)were higher than before treatment(P<0.05);however,there was no significant difference in TBIL,ALT,ALB,PTA among the groups(P>0.05).The prothrombin time(PT)in group C was higher than that in group A and group B,but the activated partial thromboplastin time(APTT),thrombin time(TT),and fibrinogen(Fib)were lower than those in group A and group B(P<0.05).After 3 months and 6 months of treatment,there was no significant difference in survival rates between the three groups(P>0.05).Conclusions Plasma perfusion mode,hemodiafiltration mode and combination therapy can improve liver function,coagulation function and survival rate in patients with acute liver failure.

关 键 词：人工肝 急性肝衰竭 肝功能 凝血功能 

分 类 号：R575.3[医药卫生—消化系统]