连续性静脉-静脉血液净化辅助治疗儿童急性肝功能衰竭的临床分析  

Clinical analysis of continuous veno-venous hemofiltration on adjuvant therapy of acute liver failure

作　　者：林益虎 朱广福 Lin Yihu;Zhu Guangfu(The Women's and Children's Hospital of Quanzhou City,Quanzhou Fujian 362000)

机构地区：[1]泉州市儿童医院,福建泉州362000

出　　处：《基层医学论坛》2022年第19期8-10,67,共4页The Medical Forum

摘　　要：目的探讨连续性静脉-静脉血液净化辅助治疗儿童急性肝功能衰竭的临床效果。方法回顾性分析2014年1月-2020年1月泉州市儿童医院接收的30例儿童急性肝功能衰竭患者资料,其中15例仅接受基础急救治疗,纳入对照组;另外15例在常规急救的基础上采取连续性静脉-静脉血液净化辅助治疗(即血浆置换加血液滤过透析)纳入研究组。比较2组患儿治疗前后的实验室相关指标与凝血功能。结果治疗前,2组相关肝功能指标对比差异无统计学意义(P>0.05);治疗后12~48 h时,2组TBA、TBi L、AST、ALT均明显降低,且研究组TBil、AST、ALT低于对照组,差异有统计学意义(P<0.05)。治疗前,2组凝血功能对比差异无统计学意义(P>0.05);治疗后12~48 h,2组PT明显降低、TT延长,而APTT与治疗前无明显差异(P>0.05),但组间比较无明显差异(P>0.05)。结论予以急性肝功能衰竭患儿血浆置换加血液滤过透析的疗效确切,肝功能指标得到明显好转,治疗期间及时对凝血功能监测并调整用药,能减少出血率,提升长期生存率。Objective To discuss the clinical effects of continuous veno-venous hemofiltration on adjuvant therapy of acute liver failure. Methods 30 acute liver failure children treated from January 2014 to January 2020 in our hospital were reviewed. After admission to hospital,the health education for family members was given while the informed contents were signed. 15 cases of taking the basic emergency treatment were included in the control group;15 cases of taking the routine emergency treatment and continuous veno-venous hemofiltration(plasma exchange and hemofiltration)were included in the study group. Laboratory index and blood coagulation function were compared. Results Before treatment,laboratory index between groups showed no statistically significant difference(P>0.05);after 12h-48h of treatment,TBA(total bile acid),TBil(total bilirubin),AST(aspartate aminotransferase)and ALT(alanine aminotransferase)values for two groups were obviously declined,but TBi L,AST and ALT values in the study group were even lower than control group(P<0.05)before treatment,blood coagulation indicators between groups showed no statistically significant difference(P>0.05);after 12h-48h of treatment,PT(prothrombin time)for two groups was shortened while TT(thrombin time)was extended(P<0.05);before and after treatment,APTT(activated partial thromboplastin time)for two groups showed no statistically significant difference(P>0.05);APTT between groups showed no statistically significant difference(P>0.05). Conclusion The plasma exchange and hemofiltration can remarkably improve the children’s liver function index. During treatment,the blood coagulation function can be properly monitored to adjust the medical drugs,reduce the bleeding rate and extend the survival rate.

关 键 词：儿童急性肝功能衰竭 连续性静脉-静脉血液净化 血浆置换 血液滤过透析 

分 类 号：R575.3[医药卫生—消化系统]