三种不同模式人工肝治疗肝衰竭患者的临床研究  

Clinical Study of Three Different Modes of Artificial Liver Treatment in Patients with Liver Failure

作　　者：叶晓玲[1] 吴锦瑜 吴刚[1] Ye Xiao-ling;Wu Jin-yu;Wu Gang(Department of Liver Diseases,Jiujiang First People's Hospital,Jiujiang 332000,Jiangxi Province,China)

机构地区：[1]九江市第一人民医院肝病科,江西九江332000

出　　处：《罕少疾病杂志》2023年第10期71-73,共3页Journal of Rare and Uncommon Diseases

基　　金：江西省卫健委立项课题(202140309)。

摘　　要：目的比较三种不同模式人工肝治疗用于肝衰竭患者的效果。方法选取2021.01-2023.01本院收治的肝衰竭患者总共90例进行研究,结合随机数字表法分成A、B、C三组各有30例,A组予以双重血浆分子吸附加血浆置换(DPMAS+PE),B组予以血浆滤过透析(PDF),C组予以血浆置换(PE),观察三组治疗前后的症状改善、疗效及化验指标改变情况,包含血清中总胆红素(TBIL)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、白蛋白(ALB)、血肌酐(CR)、尿素氮(BUN)、钠离子(Na+)、凝血酶原活动度(PTA)、白细胞(WBC)、血红蛋白(HGB)、血小板(PLT)变化,并统计不良反应和12周生存率。结果三组治疗后的临床症状存在程度不一改善,主要表现是食欲改进、腹胀缓解、乏力减轻、浮肿减退以及尿量增加等。三组有效率、不良反应和12周生存率相比无显著差异(P>0.05)。三组治疗前的ALT、AST、TBIL、CR、BUN、Na+、ALB、PTA、WBC、HGB、PLT相比无显著差异(P>0.05);治疗后,各组各项指标均较前改善(P<0.05),其中B组治疗后的Na+较前升高,A、C组较前降低,组间相比差异显著(P<0.05);C组治疗后的ALB、PTA较前升高,A、B组较前降低,组间相比差异显著(P<0.05);余下指标相比均无显著差异(P>0.05)。结论DPMAS+PE、PDF、PE三种模式人工肝用于肝衰竭患者的疗效、预后以及安全性相当,均能改善肝肾功能、凝血功能以及血常规指标,纠正钠离子紊乱,需要临床结合患者病情开展个体化指标,才能使患者获得最佳的治疗效果。Objective To compare the effects of three different modes of artificial liver therapy in patients with liver failure.Methods A total of 90 patients with liver failure admitted to 2021.01-2023.01 were selected for study,Combined with the random number table method,A,B,C three 30 cases,Group A was given as dual plasma molecular adsorption plus plasma exchange(DPMAS+PE),Group B received plasma filtration dialysis(PDF),Group C for plasma exchange(PE),The symptom improvement,efficacy and change of laboratory indicators before and after treatment in the three groups were observed,It includes total serum bilirubin(TBIL),alanine aminotransferase(ALT),aspartate aminotransferase(AST),albumin(ALB),blood creatinine(CR),urea nitrogen(BUN),and sodium ion(Na+),Changes in prothrombin activity(PTA),white blood cells(WBC),hemoglobin(HGB),platelet(PLT),and statistical adverse reactions and 12-week survival rate.Results The improvement of clinical symptoms varied in the three groups after treatment,and the main manifestations were the improvement of appetite,relief of abdominal distension,reduced fatigue,decreased edema and increased urine output.There was no significant difference in response rate,adverse effects and 12-week survival among the three groups(P>0.05).ALT,AST,TBIL,CR,BUN,Na before the three groups+,ALB,PTA,WBC,HGB,PLT(P>0.05);after treatment,the indicators in each group improved(P<0.05),including group B Na after treatment+Groups A,C decreased significantly(P<0.05);ALB,PTA,group A,B(P<0.05);no remaining indicators(P>0.05).Conclusion The efficacy,prognosis and safety of DPMAS+PE,PDF and PE modes of artificial liver in liver failure patients are comparable,all can improve liver and kidney function,coagulation function and blood routine indicators,and correct sodium ion disorder.It is necessary to combine the patient's condition,so as to achieve the best treatment effect for patients.

关 键 词：人工肝 血浆置换 双重血浆分子吸附 血浆滤过透析 肝衰竭 

分 类 号：R322.47[医药卫生—人体解剖和组织胚胎学]