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双重血浆分子吸附联合血浆置换治疗慢加急性肝衰竭的疗效分析

  

  1. 兰州市第二人民医院 感染性疾病科,甘肃  兰州 730046
  • 出版日期:2019-07-20 发布日期:2019-08-24
  • 通讯作者: 秦华,Email: qinhua800@126.com

Clinical effect of double plasma absorption combined with plasma exchange  therapy in  acuteonchronic liver failure

  1. Department of Infectious Diseases,  the Second People’s Hospital of Lanzhou, Lanzhou 730046, China
  • Online:2019-07-20 Published:2019-08-24
  • Contact: Correspondingauthor: Qin Hua, Email: qinhua800@126.com

摘要: 目的  观察双重血浆分子吸附系统(DPMAS)联合血浆置换(PE)治疗慢加急性肝衰竭(ACLF)的疗效及安全性。方法   回顾性分析2016年1月至2018年12月我科收治并行人工肝治疗的乙型肝炎ACLF患者69例,其中DPMAS联合PE组32例,单纯PE组37例。观察两组治疗前后血清生化指标、凝血指标和血小板(PLT)的变化,观察疗效及不良反应。结果  两组4周总有效率和12周生存率差异无统计学意义。两组治疗后总胆红素(TBil)、白蛋白(ALB)、总胆汁酸(TBA)差异有统计学意义。两组治疗后与治疗前比较,肝功能及凝血功能均明显好转,差异有统计学意义;联合组PLT治疗前后差异有统计学意义。两组不良反应发生率差异无统计学意义(P>0.05)。结论  DPMAS联合PE治疗ACLF疗效确切,能减少血浆用量,安全性较高。

关键词: 肝功能衰竭, 肝, 人工, 血浆置换, 双重血浆分子吸附系统

Abstract: Objective   To investigate the efficacy and safety of double plasma absorption(DPMAS) combined with plasma exchange (PE) in the treatment of acuteonchronic liver failure.Methods   Totally 69 cases of acuteonchronic liver failure treated with artificial liver treatment  were  retrospectively analyzed since January 2016  to December 2018. The patients were divided into combination group with 32 patients(DPMAS combined with PE)and control group with 37 patients(PE alone). Changes in laboratory tests,  clinical effection and adverse reaction before  and after different modes of treatment were compared. Results  The two groups showed no significant differences in the effectiveness and 12week survival rate. After treatment,  the levels of TBil, ALB and TBA in combination group were significantly improved than those of control group. There were significant  differences in liver function and blood coagulation function before and after treatment between two groups. Conclusion  The treatment of DPMAS  combined with PE  can improve liver  function and blood coagulation function  in comparison with simple PE.

Key words: liver failure, liver, artificial, plasma exchange;double plasma absorption