人工肝支持系统治疗重型病毒性肝炎的临床观察

A Preliminarily Clinical Study of Artificial liver Support System on the Treatment of Patients with Severe Viral Hepatitis

目的:初步观察人工肝支持系统(ALSS)血浆置换(PE)术治疗重型病毒性肝炎的临床疗效及安全性。方法:对30例重型肝炎患者应用PE治疗45例次,通过比较治疗前后患者临床症状、肝功能、凝血酶原活动度等指标判断临床疗效、观察与治疗相关的不良反应及患者耐受情况判断其安全性和可行性。结果:血浆置换术后重型肝炎患者自觉症状明显改善达87%,血清胆红素平均降低34.3%,PTA上升13%。治疗过程中以血压下降、心慌、恶心、过敏等不良反应发生率20%,未发生大出血、休克等严重并发症和血制品引起的重叠感染,耐受情况良好。结论:PE可显著改善肝功能衰竭患者临床症状及生化指标,提高近期存活率,且安全可行。

Objective:In order to evaluate the efficacy and safety of artificial liver support systems(plasma exchange)on patients with severe viral hepatitis.Methods:30 Case suffering from fulminant hepatic failure were treated with plasma exchange.Before and after treatment,the liver function,serum ammonia,and prothrombin activity were examined,and the treatment-related side effect were recorded as well.Other 30 cases with similar condition were compared as control.Results:The patients which underwent artifical liver treatment showed significant improvements in clinical symptoms(87%),and blood data,including serum total bilirubin(34.3%),ammonia,prothrombin activity(13%).No severe complication such as large hemorrhage,shock,and superinfection were found.All patients in treatment group were well tolerated to the therapices.Conclusions:PE treatment can effectively remove the pathological compositions such as serum bilirubin,ammonia,total acids etc,out of the body.Use of the PE to treat 30 cases were tolerated with evidence of clinical improvement and mild side effects.