血液净化治疗妊娠急性脂肪肝器官功能障碍的体会

Clinical research on blood purification for the treatment of severely acute fatty liver of pregnancy

目的探讨血液净化治疗在抢救妊娠急性脂肪肝(AFLP)器官功能障碍中的临床意义。方法13例诊断为AFLP器官功能障碍患者在护肝、抗炎、补液等常规治疗和中止妊娠的基础上,早期给予血液净化治疗。观察患者生命体征,检测血胆红素、转氨酶、凝血功能、血糖、血小板等主要实验室指标的变化。结果通过血液净化治疗的13例AFLP器官功能障碍患者血胆红素、转氨酶、凝血功能、血小板、血糖等指标和炎症细胞因子IL-6、TNF-α与治疗前比较有显著改善(P<0·05);临床观察1个月,13例患者全部治愈。结论血液净化治疗AFLP器官功能障碍患者可提高抢救成功率,降低孕产妇死亡率。

Objective To investigate the clinical effect of the blood purification on the patients with the severely acute fatty liver of pregnancy. Method Termination of pregnancy and early blood purification were used for 13 cases definitely diagnosed as acute fatty liver of pregnancy after the treatment of protecting liver, antiinflammation and fluid replacement. Vital sign was observed, hemobilirubin, aminotransferase,coagulation function, blood glucose and blood platelet were detected. Result 13 cases were alive, their hemobilirubin, aminotransferase, coagulation function, blood glucose and blood platelet, IL - 6, TNF - α were better after the treatment and there was statistical significance. Conclusion The treatment of early plasmapheresis and blood purification can decrease the maternal mortality and increase the cure rate in the patients with acute fatty liver of pregnancy after termination of pregnancy.