不同人工肝治疗在急性肝衰竭治疗中的临床疗效对比研究  

Comparative Study on Clinical Effect of Different Artificial Livers in Treatment of Acute Hepatic Failure

作　　者：吴晓文[1] 李军[1] 尧国胜[1] 韦凌云 黄高[1] WU Xiaowen;LI Jun;YAO Guosheng;WEI Lingyun;HUANG Gao(ICU Department,Youjiang Medical University for Nationalities Affiliated Hospital,Baise,Guangxi 533000)

机构地区：[1]右江民族医学院附属医院重症医学科,广西百色533000

出　　处：《智慧健康》2024年第25期96-98,101,共4页Smart Healthcare

摘　　要：目的 分析在急性肝衰竭治疗中采取不同人工肝治疗的临床疗效。方法 回顾性分析2021年6月—2023年6月入住本院重症医学科治疗的90例急性肝衰竭患者的临床资料,所有患者在重症医学科综合治疗的基础上,给予人工肝支持治疗。将所有患者随机分为A、B、C三组,每组30例。其中,A组行血浆置换治疗,B组行双重血浆分子吸附系统治疗,C组行血浆置换+双重血浆分子吸附系统治疗;比较分析三组患者治疗前后肝功能[总胆红素(TBIL)、直接胆红素(DBIL)、血清丙氨酸转氨酶(ALT)、血清谷丙转氨酶(AST)]、凝血功能[凝血酶原活动度(PTA)、凝血酶(PT)]、炎症指标[超敏C反应蛋白(CRP)、降钙素原(PCT)]。结果 治疗前,三组肝功能、凝血功能与炎症指标对比,差异无统计学意义(P>0.05);治疗后,C组患者肝功能、PT水平与炎症指标明显更低于B组与A组,PTA水平更高于A组、B组;B组肝功能、PT水平与炎症指标明显更低于A组,PTA水平更高于A组,组间差异有统计学意义(P<0.05)。结论 在急性肝衰竭治疗中采取血浆置换联合双重分子吸附系统治疗可明显改善患者肝功能,较单独血浆置换或血浆分子吸附系统治疗更有助于降低炎症水平,恢复凝血功能,值得推广应用。Objective To analyze clinical effect of different artificial liver treatments for acute hepatic failure.Methods The paper reviewed and analyzed general information of 90 patients with acute hepatic failure in ICU of our hospital from June 2021 to June 2023,treated with artificial liver support therapy based on comprehensive treatment in ICU,and divided them into groupA,B and C randomly.Group A was treated with plasma exchange treatment,group B with dual plasma molecular adsorption system treatment,and group C with plasma exchange+dual plasma molecular adsorption system treatment.Liver function(total bilirubin(TBIL),direct bilirubin(DBIL),serum alanine aminotransferase(ALT),serum alanine aminotransferase(AST)),coagulation function(prothrombin activity(PTA),thrombin(PT))and inflammatory indicators(high-sensitivity C-reactive protein(CRP),procalcitonin(PCT))were compared and analyzed of three groups before and after treatment.Results Before treatment,there was no statistically significant difference in liver function,coagulation function,and inflammatory indicators among three groups(P>0.05).After treatment,liver function,PT levels,and inflammatory indicators in group C were significantly lower than group B and A,and PTA levels were higher than group A and B.Liver function,PT levels,and inflammatory markers in group B were significantly lower than group A,while PTA level was higher than group A,with statistical significance(P<0.05).Conclusion Combination of plasma exchange and dual molecular adsorption system can significantly improve liver function of acute liver failure,help reduce inflammation levels and restore coagulation function better than plasma exchange or plasma molecular adsorption system only,which is worthy of promotion and application.

关 键 词：人工肝 急性 肝衰竭 

分 类 号：R575.3[医药卫生—消化系统]