胆红素吸附联合血浆置换对重症肝衰的治疗效果观察  

Observation on the Therapeutic Effect of Bilirubin Adsorption Combined with Plasma Exchange on Severe Liver Failure

作　　者：周美琴 ZHOU Meiqin(Department of Hemodialysis,the Second Hospital of Middle School of Jiangsu Province,Nanjing Jiangsu 210000)

机构地区：[1]江苏省第二中医院血透室,江苏南京210000

出　　处：《智慧健康》2023年第30期94-97,共4页Smart Healthcare

摘　　要：目的观察胆红素吸附(PBA)联合血浆置换(PE)在重症肝衰治疗中的应用效果,探究该治疗方案的实施价值。方法获伦理委员会审批,选取2020年6月—2022年12月本院收治的84例确诊为重症肝衰患者作为研究对象。结合患者的情况差异,遵循随机性原则,采用系统随机化法分为对照组与观察组,每组42例,对照组接受PE治疗,观察组接受PBA+PE治疗,根据多项观察指标,评估并比较两组疗效。结果治疗后,观察组各项肝功能指标优于对照组,具体表现为ALT、AST、DBIL、IBIL、TBIL更低,对比均具有显著差异(P<0.05)。治疗后,观察组各项血清内毒素指标和细胞因子指标均优于对照组,具体表现为LPS、IL-1、IL-6、TNF-α更低,对比均具有显著差异(P<0.05)。观察组治疗有效率高于对照组(P<0.05),不良反应发生率低于对照组(P<0.05)。结论PBA与PE在重症肝衰中的联合应用可取得良好疗效,在改善肝功能指标、提高治疗有效率、降低血清细胞因子水平、减少不良反应发生四大方面均有积极作用,值得进一步研究和大范围推广。Objective To observe the effect of bilirubin adsorption(PBA)combined with plasma exchange(PE)in the treatment of severe liver failure,and to explore the implementation value of the treatment.Methods Approved by the Ethics Committee,this clinical controlled trial took 84 patients diagnosed with severe liver failure and complete data from 2020.06 to 2022.12 admitted to our hospital as the study object.According to the differences in patients'conditions,following the principle of randomness and systematic randomization,the subjects were divided into control group and observation group with 42 cases in each group.The former received PE treatment and the latter received PBA+PE treatment.The efficacy of the two groups was evaluated and compared according to a number of observation indicators.Results After treatment,the liver function indexes of the observation group were better than those of the control group,including lower ALT,AST,DBIL,IBIL and TBIL,with significant differences in comparison(P<0.05).After treatment,the indexes of serum endotoxin and cytokines in the observation group were better than those in the control group,and the specific manifestations were lower LPS,IL-1,IL-6 and TNF-a,with significant differences(P<0.05).The effective rate of treatment in observation group was higher than that in control group(P<0.05),and the incidence of adverse reactions was lower than that in control group(P<0.05).Conclusion The combined application of PBA and PE in severe liver failure can achieve good curative effect,and has positive effects on improving liver function index,increasing treatment efficiency,reducing serum cytokine level and reducing adverse reactions,which is worthy of further study and large-scale promotion.

关 键 词：重症肝衰 胆红素吸附 血浆置换 治疗效果 

分 类 号：R575.3[医药卫生—消化系统]