胆红素吸附柱联合血液灌流器的吸附系统治疗高胆红素血症的效果

Effect of an adsorption system of bilirubin adsorption column combined with disposable hemoperfutor for hyperbilirubinemia

目的：考察胆红素吸附柱联合血液灌流器的吸附系统治疗高胆红素血症的临床效果、护理方式与安全性。方法本文回顾性分析昆明医科大学附属延安医院在2012年9月~2013年12月收治的30例高胆红素血症患者，所有患者在药物综合治疗的基础上接受了这种组合式的治疗方法，患者的血液经过血浆分离器分离出血浆后经血液灌流器（MG-350）吸附后再通过胆红素吸附柱回输至体内。观察和检测患者治疗前后的症状、体征、肝功能、凝血酶原活性、血常规、电解质、炎性因子及治疗中发生的并发症。结果30例患者接受该吸附系统治疗后其体内的总胆红素、直接胆红素、间接胆红素、总胆汁酸的下降幅度为（189.93±95.14）、（106.57±60.71）、（87.81±58.39）、（64.84±26.30）μmol/L。治疗前后比较差异有统计学意义（P〈0.05）。结论观察胆红素吸附柱联合血液灌流器的吸附系统是一种新型有效的人工肝支持治疗，可显著降低患者的胆红素水平，改善生化检查指标及部分临床症状，且患者耐受性好。因此，血浆分离灌流方法是一种值得在临床推广应用的人工肝支持疗法。

Objective To investigate the therapeutic effect, the nursing methods and the security of the adsorption sys-tem of bilirubin adsorption column combined with disposable hemoperfutor which applied to hyperbilirubinemia. Meth-ods In this paper, a retrospective analysis of a total of 30 patients with hyperbilirubinemia in Yan＇an Hospital Affiliated to Kunming Medical University from September 2012 to December 2013 were enrolled. They were treated with the ad-sorption system on the basis of medicine comprehensive treatment, the patients＇ blood was separated by a plasma sepa-rator plasma then passed a disposable hemoperfutor （MG-350） and bilirubin adsorption column, and then the plasma reflowed back to the body in the end. Their main symptoms, signs, liver function, prothrombin activity, blood count, electrolytes and complications therapy in treatment were observed. Results After treated with the adsorption system, all patients＇ TBiL, DBiL, IBiL, TBA were significantly lower than before treatment, the reduction was （189.93±95.14）, （106.57±60.71）, （87.81±58.39）, （64.84±26.30） μmol/L, respectively. The differences between before and after treatment were statistically significant （P 〈 0.05）. Conclusion The adsorption system of bilirubin adsorption column combined with disposable hemoperfutor is a new type of effective artificial liver support therapy, which can significantly reduce bilirubin in the body and improve biochemical parameters, and has good patients＇ tolerance. So the plasma separation perfusion method is worthy of clinical application of artificial liver support therapy.