人工肝血浆置换治疗124例肝衰竭的临床观察

The clinical observation of artificial liver support system in the treatment of 124 patients with liver failure

目的观察血浆置换(PE)术治疗肝衰竭的临床疗效、安全性及转归。方法对124例肝衰竭患者应用PE治疗223例次,通过比较治疗前后患者临床症状、血生化指标、凝血酶原时间等指标判断临床疗效,观察治疗相关的不良反应及转归情况。结果血浆置换术后自觉症状改善者达58.3%,血清胆红素显著下降(P<0.01),凝血酶原时间显著缩短(P<0.01)。治疗过程中出现血压一过性下降、皮疹、心慌、烦躁等不良反应,经对症处理后好转,未发生严重并发症。早期及中晚期肝衰竭的患者好转率分别为89.5%及12.5%(P<0.005),存在显著差异。结论PE可显著改善肝功能衰竭患者的临床症状及血生化指标,且安全可行。

Objective To observe the efficacy and safety of artificial liver support system in treatment of patients with liver failure. Methods 124 patients with liver failure were treated with plasma exchange. Before and after treatment, the clinical symptom, liver function tests and prothrombin time activity were examined. Results The patients after plasma exchange had an significant improvements in clinical symptoms（58.3%） and total serum bilirubin （P〈0.01）and prothrombin time （P〈0.01） declined. No severe complications were found. 41 patients recovered, 21 died and 62 discharged with deteriorated liver functions. Conclusions PE can effectively alleviate clinical symptoms, improve liver function and is an effective treatment for patients with liver failure.