双重血浆吸附系统联合(半量)血浆置换治疗肝衰竭及高胆红素血症的临床应用研究  

Clinical Application of Dual Plasma Adsorption System Combined With(Half-Volume) Plasma Exchange in the Treatment of Liver Failure and Hyperbilirubinemia

作　　者：郑泳森 高敬国 ZHENG Yongsen;GAO Jingguo(Department of Critical Care Medicine,Zhongshan Tanzhou People's Hospital,Zhongshan Guangdong 528467,China)

机构地区：[1]中山市坦洲人民医院重症医学科,广东中山528467

出　　处：《中国卫生标准管理》2023年第17期110-113,共4页China Health Standard Management

基　　金：广东省中山市社会公益与基础研究项目(210325173942390)。

摘　　要：目的 分析肝衰竭及高胆红素血症患者给予双重血浆吸附系统联合(半量)血浆置换治疗的临床效果。方法 将中山市坦洲人民医院2020年7月—2023年5月收治的肝衰竭及高胆红素血症患者60例作为研究对象,根据是否同意人工肝治疗分为观察组与对照组,各30例。对照组进行常规治疗,观察组在对照组的基础上给予双重血浆吸附系统联合(半量)血浆置换治疗。比较两组治疗前后肝功能、总胆汁酸水平、胆红素水平、炎症因子水平以及28 d生存率。结果 治疗后两组丙氨酸转氨酶(alanine aminotransferase,ALT)、天冬氨酸转氨酶(aspartate aminotransferase,AST)均有下降,且观察组低于对照组(P <0.05)。两组白蛋白(albumin,ALB)均有上升,且观察组高于对照组,差异有统计学意义(P <0.05)。治疗后两组总胆汁酸、总胆红素(total bilirubin,TBIL)水平均有下降,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后两组降钙素原(procalcitonin,PCT)、白介素6(interleukin-6,IL-6)、C反应蛋白(C-reactive protein,CRP)水平均有下降,且观察组低于对照组,差异有统计学意义(P <0.05)。观察组28 d生存率(93.33%)高于对照组(73.33%),差异有统计学意义(P <0.05)。结论 通过双重血浆吸附系统联合(半量)血浆置换治疗,能够使肝衰竭及高胆红素血症患者改善肝功能水平,降低总胆汁酸和总胆红素,改善炎症因子水平,在这些基础上提高治疗效果,提升肝衰竭及高胆红素血症患者28 d生存率。Objective To analyse the clinical outcome of a dual plasma adsorption system combined with(half-volume)plasma exchange given to patients with hepatic failure and hyperbilirubinaemia.Methods A total of 40 cases of patients with liver failure and hyperbilirubinemia admitted to Zhongshan Tanzhou People's Hospital from July 2020 to May 2023 were taken as the study objects,and they were randomLy divided into 20 cases each in the observation group and the control group according to the time of admission.The control group underwent conventional treatment,while the observation group was given dual plasma adsorption system combined with(half-volume)plasma exchange therapy on the basis of the control group,so as to compare the liver function,the level of total bile acid,the level of bilirubin,the level of inflammation factor,and the survival rate before and after the treatment of the two groups for 28 d.Results After treatment,alanine aminotransferase(ALT),aspartate aminotransferase(AST),decreased in both groups,and the observation group was lower than the control group(P<0.05).Both groups showed an increase in albumin(ALB),and the observation group was higher than the control group,with a statistically significant difference(P<0.05).After treatment,the levels of total bile acids and total bilirubin in both groups decreased,and there was a statistically significant difference between the observation group and the control group(P<0.05).After treatment,the levels of procalcitonin(PCT),interleukin-6(IL-6),and C-reactive protein(CRP) in both groups decreased,and the observation group was lower than the control group,with a statistically significant difference(P<0.05).The 28 d survival rate(93.33%) of the observation group was higher than that of the control group(73.33%),and the difference was statistically significant(P<0.05).Conclusion Through the dual plasma adsorption system combined with(halfvolume) plasma exchange treatment,it can enable patients with liver failure and hyperbilirubinaemia to improve the level of hepatic

关 键 词：双重血浆吸附系统 (半量)血浆置换治疗 肝衰竭 高胆红素血症 肝功能 临床应用 

分 类 号：R575[医药卫生—消化系统]