血液灌流治疗慢性重型肝炎的近期临床观察

Clinical observation of hemoperfusion on chronic severe liver diseases

目的 探讨体外血液灌流人工肝支持治疗对慢性重型肝病的临床疗效。方法 运用单泵进行活性炭血液灌流治疗慢性重型肝炎或肝硬化伴肝性脑病患者 ,观察治疗前后临床症状、血常规、肝功能、电解质及血氨的变化 ,判定疗效。结果 血液灌流可改善肝性脑病症状 ,使总胆红素及血氨明显降低。结论 血液灌流可清除患者体内引起肝细胞损害的有毒代谢物质 ,从而改善肝功能 ,特别是提高肝性脑病的清醒率 ,为肝细胞再生创造条件 ,也是肝移植待供肝的前期重要准备工作 ,且简单、安全 ,适合临床开展 。

Objective To investigate the clinical efficacy of hemoperfusion on chronic severe liver diseases. Methods Total eight patients with hepatic encephalopathy of chronic severe hapatitis or liver cirrhosis were treated by charcoal hemoperfusion. Results Clinical features of hepatic encephalopathy after treatment were significantly improved. Total bilirubin and blood ammonia was significantly decreased. Conclusion Charcoal hemoperfusion, which may result in early recovering of consciousness, is useful in patients with chronic severe liver diseases and has been suggested as a bridge to liver transplantation. However further study is still required.