双重血浆分子吸附序贯血浆置换治疗肝衰竭的临床疗效分析  

Analysis on clinical efficacy of dual plasma molecular adsorbent sequential plasma exchange in treatment of liver failure

作　　者：刘倩 陈荣 李明丹 张滢 代梅 徐亚丽 杨平 罗亚文 LIU Qian;CHEN Rong;LI Mingdan;ZHANG Ying;DAI Mei;XU Yali;YANG Ping;LUO Yawen(Department of Nursing,Affiliated Hospital of Zunyi Medical University,Zunyi,Guizhou 563000,China;Department ofInfection,Affiliated Hospital of Zunyi Medical University,Zunyi,Guizhou 563000,China;School of Nursing,Zunyi Medical University,Zunyi,Guizhou 563000,China)

机构地区：[1]遵义医科大学附属医院护理部,贵州遵义563000 [2]遵义医科大学附属医院感染科,贵州遵义563000 [3]遵义医科大学护理学院,贵州遵义563000

出　　处：《重庆医学》2025年第3期588-592,共5页Chongqing Medical Journal

基　　金：贵州省科技计划项目(黔科合支撑[2021]一般049)。

摘　　要：目的探讨双重血浆分子吸附(DPMAS)序贯血浆置换(PE)人工肝模式治疗肝衰竭的临床疗效。方法选取2020年1月至2023年12月遵义医科大学附属医院接受人工肝治疗的85例肝衰竭患者为研究对象,根据治疗模式不同分为研究组(n=52)及对照组(n=33),研究组行DPMAS序贯PE治疗,对照组行PE治疗。比较两组治疗前及第1、2次治疗后24 h肝功能[总胆红素(TBIL)、ALT、AST、血清白蛋白(ALB)、球蛋白(GLO)、前白蛋白(PAB)]、血红蛋白(Hb)、凝血功能[PLT、凝血酶原活动度(PTA)、国际标准化比值(INR)、纤维蛋白原(FIB)]水平变化情况。结果与治疗前比较,第1、2次治疗后两组TBIL、ALT、AST、GLO、Hb降低,对照组ALB和第2次治疗后两组PAB水平升高(P<0.05)。与第1次治疗后比较,第2次治疗后两组TBIL、ALT、GLO水平及研究组AST、Hb水平降低,研究组ALB及两组PAB水平升高(P<0.05)。与治疗前比较,第1次治疗后两组PLT、FIB及对照组INR水平降低,对照组PTA水平升高(P<0.05)。与治疗前比较,第2次治疗后两组PLT、INR、FIB水平降低,PTA水平升高(P<0.05)。与第1次治疗后比较,第2次治疗后研究组PTA水平升高,INR水平降低(P<0.05)。结论PE、DPMAS序贯PE均能改善肝衰竭患者的肝功能,且治疗2次效果更为明显。Objective To explore the clinical efficacy of dual plasma molecular adsorption(DPMAS)sequential plasma exchange(PE)artificial liver mode in the treatment of liver failure(LF).Methods Eighty-five patients with LF receiving the artificial liver treatment in the Affiliated Hospital of Zunyi Medical University from January 2020 to December 2023 were selected as the study subjects and divided into the study group(n=52)and the control group(n=33)according to the different treatment modes.The study group conducted DPMAS sequential PE treatment and the control group underwent the PE treatment.The liver function[total bilirubin(TBIL),alanine aminotransferase(ALT),aspartate aminotransferase(AST),serum albumin(ALB),globulin(GLO),prealbumin(PAB)],Hb,coagulation function[platelet(PLT),plasminogen activity(PTA),international normalized ratio(INR),fibrinogen(FIB)]before treatment and at 24 h after treatment were compared between the two groups.Results Compared with before treatment,the levels of TBIL,ALT,AST,GLO and Hb after the first and second treatment in the two groups were decreased,ALB level in the control group and PAB level after the second time treatment was increased(P<0.05).Compared with after the first treatment,the levels of TBIL,ALT and GLO after the second treatment in the two groups and the levels of AST and Hb in the study group were decreased,ALB level in the study group and PAB level in the two groups were increased(P<0.05).Compared with before treatment,the levels of PLT and FIB after the first treatment in the two groups and INR level in the control group were decreased,PTA level in the control group was increased(P<0.05).Compared with before treatment,the levels of PLT,INR and FIB after the second treatment in the two groups were decreased,PTA level was increased(P<0.05).Compared with before treatment,the levels of PLT,INR and FIB after the second treatment in the two groups were decreased,and PTA level was increased(P<0.05).Compared with after the first treatment,PTA level after the second treatment in th

关 键 词：肝衰竭 双重血浆分子吸附 血浆置换 人工肝 凝血功能 

分 类 号：R575.3[医药卫生—消化系统]