血浆置换联合双重血浆分子吸附系统在肝衰竭患者中的应用研究  

Study on the Application of Plasma Replacement(PE)Combined with Dual Plasma Molecular Adsorption System(DPMAS)in Patients with Liver Failure

作　　者：李明友[1] 王琪 杨旭[1] 李扬 Li Mingyou;Wang Qi;Yang Xu(Jiamusi Infectious Disease Hospital,Jiamusi,Heilongjiang,154007,China)

机构地区：[1]佳木斯市传染病院,黑龙江佳木斯154007

出　　处：《黑龙江医学》2025年第4期410-412,共3页Heilongjiang Medical Journal

基　　金：黑龙江省卫生健康委基金项目(20210303100393)。

摘　　要：目的:分析一家三级甲等传染病专科医院血浆置换(PE)联合双重血浆分子吸附系统(DPMAS)在肝衰竭患者中的应用效果。方法:选取2020年3月-2023年3月就诊于佳木斯市传染病院的60例肝衰竭患者作为研究对象,根据治疗方法不同分为对照组和实验组,每组各30例。对照组采用内科治疗(一般支持治疗+药物治疗),实验组在内科治疗基础上先行DPMAS治疗后再行PE治疗。检测两组患者肝功能和血凝结果,并对患者治疗情况及其他临床检查结果进行追踪。结果:治疗后,两组患者生化血清学指标谷丙转氨酶(ALT)、天门冬氨酸转氨酶(AST)、碱性磷酸酶(ALP)、白蛋白(ALB)指标优于治疗前,差异均有统计学意义(t=5.079、2.222、6.304、-0.682,P<0.05)。对照组患者治疗后总胆红素(TBIL)水平较治疗前无明显变化,实验组患者治疗后TBIL水平较治疗前明显下降,但治疗24 h后迅速回升。在治疗期间24~72 h,TBIL呈缓慢上升趋势。治疗后即刻、治疗后24 h和72 h TBIL水平较治疗前显著降低。治疗后,两组患者凝血功能指标凝血酶原时间(INR)、凝血酶原活动度(PTA)优于治疗前,差异均有统计学意义(t=8.090、-10.704,P<0.05),对照组患者治疗后INR和PTA水平变化比较,差异无统计学意义(P>0.05),实验组患者治疗后PTA水平明显升高,差异有统计学意义(P<0.05),INR明显低于治疗前,差异有统计学意义(P<0.05)。结论:DPMAS+PE治疗与传统内科治疗方法相比,可以更有效的改善凝血障碍、AST、ALT等生化指标,改善肝衰竭患者的暂时性TBIL。因此,DPMAS+PE是肝衰竭患者的有效治疗方法。Objective:To analyze the application of plasma system(PE)combined with double plasma molecular adsorption system(DPMAS)in patients with liver failure in a tertiary hospital specializing in infectious diseases.Methods:The information of 60 patients treated in Jiamusi Infectious Disease Hospital from March 2020 to March 2023 was retrospectively analyzed.According to the treatment methods,they were divided into control group and experimental group,with 30 patients in each group.The control group adopted internal medicine treatment(general support treatment+drug treatment).The experimental group was treated with DPMAS treatment first and then PE treatment on the basis of internal medicine treatment.Two groups of patient samples were collected to detect liver function and blood clotting results,and track the treatment of patients and other clinical examination results.Results:Before treatment,the biochemical serological indicators ALT,AST,ALP and ALB of patients in tow groups were better than before treatment,and the differences were statistically significant(t=5.079,2.222,6.304,-0.682;P<0.05).Compared with the inter-group comparison,the experimental group showed better advantages over the control group.After treatment,the TBIL level of patients in the control group did not change significantly compared with that before treatment.After treatment,the TBIL level of patients in the treatment group decreased significantly compared with that before treatment,but rose rapidly after 24 hours of treatment.24 h 72 h after treatment,bilirubin showed a slow upward trend.The levels of TBIL immediately after treatment,24 hours and 72 hours after treatment are significantly lower than those before treatment.Before treatment,there was no statistical significance in comparison between the coagulation function index INR and PTA of patients in the two groups were better than before treatment.The difference was statistically significant(t=8.090,-10.704;P<0.05).After treatment in the treatment of patients in the control group,there was n

关 键 词：血浆置换 双重血浆分子吸附系统 肝衰竭 

分 类 号：R322.47[医药卫生—人体解剖和组织胚胎学]