双重血浆吸附联合血浆置换治疗肝衰竭的临床研究  

Clinical study of double plasma adsorption combined with plasma exchange in the treatment of liver failure

作　　者：陈超[1] 邱邦东[1] 叶清琦 王成军[1] 李旭[1] 姚玲[1] Chen Chao;Qiu Bangdong;Ye Qingqi;Wang Chengjun;Li Xu;Yao Ling(The First Department of Infection,the Second People's Hospital of Yibin City,Sichuan Yibin 644000)

机构地区：[1]宜宾市第二人民医院感染一科,四川宜宾644000

出　　处：《中国社区医师》2021年第29期10-11,共2页Chinese Community Doctors

摘　　要：目的:评价双重血浆吸附(DPMAS)联合血浆置换(PE)治疗肝衰竭的疗效及安全性。方法:2014年1月-2018年12月收治肝衰竭患者141例,根据不同治疗方式分为DPMAS组、PE组及DPMAS联合PE组。比较三组患者治疗前后临床症状、体征及生化指标水平变化。结果:三组均能有效降低患者血清中的总胆红素(TB)及谷丙转氨酶(ALT)水平,且PE联合DPMAS组与PE组效果相当,均优于单独的DPMAS组。PE组及PE联合DPMAS组均能提高凝血酶原活动度(PTA)水平,PE组是更优的,但单独的DPMAS组不能提高患者PTA水平。单独PE组能提高患者白蛋白(ALB)水平,PE联合DPMAS对血浆白蛋白水平基本无影响,而单独DPMAS会降低患者血浆白蛋白水平。结论:PE+DPMAS组治疗效果与血浆置换相当,同时又能显著清除炎症介质,也克服了血浆置换的不足,因此为肝衰竭患者治疗的优化模式。Objective:To evaluate the efficacy and safety of double plasma adsorption(DPMAS)combined with plasma exchange(PE)in the treatment of liver failure.Methods:From January 2014 to December 2018,141 patients with liver failure were selected.According to different treatment methods,they were divided into DPMAS group,PE group and DPMAS combined with PE group.We compared the changes of clinical symptoms,signs and biochemical indexes of the three groups before and after treatment.Results:The three groups can effectively reduce the levels of total bilirubin(TB)and alanine aminotransferase(ALT)in patients'serum,the effect of PE combined with DPMAS group was equivalent to that of PE group,which was better than that of DPMAS group alone.Both PE group and PE combined with DPMAS group can improve the level of prothrombin activity(PTA),and PE group was better,however,DPMAS group alone could not improve the level of PTA.PE group alone can increase the level of albumin(ALB),PE combined with DPMAS had no effect on plasma albumin level,DPMAS alone can reduce the level of plasma albumin.Conclusion:The therapeutic effect of PE+DPMAS group is equivalent to that of plasma exchange,at the same time,it can significantly remove inflammatory mediators and overcome the deficiency of plasma exchange,therefore,it is an optimized model for the treatment of patients with liver failure.

关 键 词：肝衰竭 人工肝 血浆置换 双重血浆吸附 

分 类 号：R575.3[医药卫生—消化系统]