分子吸附循环系统治疗重型肝炎肝功能衰竭的临床研究

Clinical study of molecular adsorbents recirculating system in the treatment of severe hepatitis liver failure

目的应用分子吸附循环系统(molecularadsorbentsrecirculatingsystem,MARS)抢救重型肝炎肝衰竭,研究其机制和疗效。方法回顾性分析30例次MARS人工肝治疗的疗效,比较治疗前后各种有毒物质的改变。结果14例重型肝炎患者MARS治疗后临床症状及体征明显改善,肝性脑病、肾功能、呼吸功能以及血流动力学紊乱也有改善,血清胆红素、血氨和血肌酐水平显著降低,凝血酶原活动度升高,肝功能酶谱、血糖、血常规等在治疗前后均无明显变化,14例重型肝炎患者8例痊愈出院或接受肝移植,总体存活率57%。结论MARS人工肝治疗为重型肝炎提供了较为有效、安全的治疗手段,也为肝移植的开展提供了条件。

Objective Molecular adsorbents recirculating system were performed in the treatment of liver failure patients of severe hepatitis in order to seek a safe and effective therapeutic method for severe hepatitis patients and evaluate the effect of treatments.Method The effect of 30 times MARS treatment were analysed. We compared the parameters in blood clinical data before and after every treatment.Result There were a remarkable improvement in clinical symptoms and physical signs,also in the patients’clinical conditions including hepatic encephalopathy,renal and respiratory function,and deranged hemodynamix situation after MARS treatment,while serum bilirubin,ammonia,urea nitrogen decreased at the same time. 8 patients were discharged from the hospital or bridged to successful liver transplantation,the overall survival rate of MARS treatment was 57%.Conclusion Molecular adsorbents recirculating system provides a safe and effective therapeutic method for severe hepatitis patients, and also provide a chance for liver transplantation. [