人工肝血浆置换治疗肝功能衰竭45例临床疗效观察

Clinical effect observation of artificial liver plasmapheresis in the treatment of 45 patients with hepatic failure

目的观察人工肝血浆置换术(PE)治疗肝功能衰竭的临床疗效和不良反应。方法对照组45例采取内科综合疗法,治疗组45例在对照组基础上,联合PE治疗,观察两组早、中、晚期及综合治疗疗效和不良反应,PE对治疗组前后的血液生化指标的影响情况。结果治疗组总有效率为80.00%,其中,早期为86.36%;对照组总有效率为51.11%,其中,早期为56.52%,二者比较差异有统计学意义(P<0.05或0.01);治疗组PE后ATL、AST、TBIL、PTA与治疗前比较差异有统计学意义(P<0.001);不良反应有皮肤瘙痒和皮疹、血压下降、肢体麻木等,经对症处理均好转。结论人工肝血浆置换治疗肝功能衰竭安全、有效,尤其适宜早期治疗。

Objective To observe the clinical effect and adverse reaction on artificial liver plasmapheresis （PE） in the treatment of hepatic failure. Methods Forty five cases of control group was given the medical comprehensive therapy, 45 cases of treatment group was given the same therapy combined with PE treatment based on the control group. Comprehensive effects and adverse reactions of two groups in the early, middle, later period, and the blood biochemical indicators of treatment group before and after treatment were observed. Results The total effective rate of treatment group was 80.00%, which was 86.36% in the early period, and the total effective rate of control group was 51.11%, which was 56.52% in the early period, there were significant differences between the two groups （P 〈 0.01 or 〈 0.05）. There were significant differences in ATL, AST, TBIL and PTA of treatment group after treatment compared with before treatment （P 〈 0.001）. There were some adverse reactions such as skin pruritus and rash, falling of blood pressure, limb numbness and so on, which took a change for the better after treatment. Conclusion Artificial liver plasmapheresis in the treatment of hepatic failure is safe, effective, and especially suitable to the early treatment.