血浆置换联合血液滤过治疗慢加急性肝衰竭合并早期肝性脑病患者的临床效果  

Clinical effect of artificial liver plasma exchange combined with hemofiltration in patients with chronic acute liver failure complicated with early hepatic encephalopathy

作　　者：王静 尚学敏 WANG Jing;SHANG Xue-min(Department of Infectious Diseases,Henan Provincial Peoples Hospital,Henan Key Laboratory of Nursing Medicine,People's Hospital of Zhengzhou University,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院感染性疾病科,河南省护理医学重点实验室,郑州大学人民医院,郑州450003

出　　处：《医药论坛杂志》2023年第18期82-85,共4页Journal of Medical Forum

摘　　要：目的 观察血浆置换联合血液滤过治疗慢加急性肝衰竭合并早期肝性脑病患者的临床效果及对肝功能的影响,并观察并发症发生情况。方法 收集2022年1月—2022年9月河南省人民医院感染性疾病科收治的慢加急性肝衰竭并早期肝性脑病80例患者,分为对照组(40例)和研究组(40例),对照组应用人工肝血浆置换治疗,研究组在对照组基础上联合开展血液滤过治疗,2周后,以疾病疗效、肝功能、凝血功能以及并发症情况作为评价指标,对比组间治疗效果。结果 治疗后,与对照组相比,研究组治疗有效率(95.00%)明显增高(χ^(2)=6.274,P<0.05);研究组的总胆红素(TBIL)、丙氨酸氨基转移酶(ALT)及白蛋白(ALB)水平均明显低于对照组(t=12.951、4.850、4.249;P<0.05);研究组凝血酶原活动度(PTA)、凝血酶原时间(PT)均低于对照组(t=2.880、6.164;P<0.05);两组并发症发生率对比则存在均衡性(χ^(2)=0.156,P>0.05)。结论 慢加急性肝衰竭并早期肝性脑病患者联合开展人工肝血浆置换术与血液滤过治疗可取得更好治疗效果,促进患者肝功能、凝血功能等改善,且安全性良好,值得推广。Objective To observe the clinical effect of plasmapheresis combined with hemofiltration on patients with chronic and acute liver failure complicated with early hepatic encephalopathy and its effect on liver function,and observe the occurrence of complications.Methods A total of 80 patients with chronic acute liver failure and early hepatic en-cephalopathy admitted to the Department of Infectious Diseases of Henan Provincial Peoples Hospital from January 2022 to September 2022 were collected and divided into control group(40 cases)and study group(40 cases).The control group was treated with artificial liver plasma exchange,and the study group jointly carried out hemofiltration treatment on the basis of the control group.The therapeutic effect of the disease,liver function,coagulation function and complica-tions were evaluated to compare the therapeutic effect between groups.Results After treatment,the effective rate of the study group was significantly increased(95.00%)compared with the control group(χ^(2)=6.274,P<0.05).The lev-els of total bilirubin(TBIL),alanine aminotransferase(ALT)and albumin(ALB)in the study group were significantly lower than those in the control group(t=12.951,4.850,4.249;P<0.05);The prothrombin activity(PTA)and prothrombin time(PT)of the study group were lower than those of the control group(t=2.880,6.164;P<0.05);The incidence of complications was balanced between the two groups(χ^(2)=0.156,P>0.05).Conclusion The com-bination of artificial liver plasma replacement and hemofiltration in patients with chronic acute liver failure and early he-patic encephalopathy can achieve better therapeutic effect,promote the improvement of liver function and coagulation function of patients,and it is safe and worthy of promotion.

关 键 词：血浆置换 血液滤过 慢加急性肝衰竭 早期肝性脑病 

分 类 号：R457[医药卫生—治疗学]