分子吸附再循环系统在肝衰竭并肝性脑病治疗中的应用

Clinical analysis of the application of molecular adsorption recirculation system on hepatic encephalopathy secondary to liver failure

目的探讨分子吸附再循环系统在肝衰竭并肝性脑病治疗中的临床应用效果。方法将我院收治的68例肝功能衰竭并肝性脑病患者,随机分为对照组和观察组。对照组采用保肝、营养支持治疗、维持水、电解质平衡等综合治疗。观察组在对照组的基础上,加用分子吸附再循环系统治疗。比较2组的治疗效果,治疗前后肝功能改善情况及治疗过程中不良反应发生情况。结果 2组治疗前总胆红素、血氨、PTA(凝血酶原活动度)、Glasgow昏迷评分差异无统计学意义(P>0.05)。观察组治疗3d后总胆红素、血氨显著低于对照组,差异有统计学意义(P<0.05)。观察组治疗后PTA、Glasgow昏迷评分显著高于对照组,差异有统计学意义(P<0.05)。观察组治疗3d后,总有效率显著高于对照组,差异有统计学意义(P<0.05)。观察组治疗3d后肝性脑病清醒率,显著高于对照组(P<0.05)。2组治疗过程中均未见严重不良反应发生。结论在综合治疗的基础上加用MARS治疗,肝功能改善显著,肝性脑病清醒率高,不良反应少,值得临床推广应用。

Objective To study the clinical application effect of molecular adsorption recirculation system on liver failure complicated with hepatic encephalopathy.Methods Sixty-eight patients with hepatic encephalopathy and liver function failure , were randomly divided into control group and observation group. Control group was treated with anti-infection ,nutrition sup-port treatment ,maintaining water and electrolyte balance and other comprehensive methods. The observation group was added with molecular adsorption recirculation system treatment. Then we compared the treatment effect of the two groups ,the liver function before and after treatment and side effects occurred in the process of treatment.Results Before treatment ,the differ-ences between the two groups in total bilirubin ,blood ammonia ,PTA （prothrombin activity） ,Glasgow coma scale had no sta-tistical significance （P〉0.05）. After treatment of 3 days ,total bilirubin and blood ammonia of the observation group were sig-nificantly lower than those of the control group ,the difference was statistically significant （P〈0.05）. PTA and Glasgow coma scale of the Observer group was significantly higher than those of the control group after treatment ,the difference was statisti-cally significant （P〈0.05）. In the treatment group ,the total effective rate was significantly higher than that of control group , the difference was statistically significant （P〈0.05）.The rate of awakening of patients with hepatic encephalopathy after treat-ment of 3 days ,is significantly higher than that of the control group （P〈0.05）. In the process of treatment ,the two groups had no serious side effects.Conclusion Treatment with MARS on the basis of comprehensive methods can make liver function improve significantly ,the awakening rate of hepatic encephalopathy higher ,has less side effects and is worthy of clinical appli-cation and popularization.