血液净化治疗肝功能衰竭患者的临床效果及护理对策

Blood purification for treatment of patients with acute liver failure:Clinical efficacy and nursing strategy

目的:研究血液净化治疗肝功能衰竭患者的临床效果及护理对策.方法:选取2007-06/2013-05唐山市工人医院收治的急性肝功能衰竭患者41例,均给予常规治疗,血浆置换联合持续静脉血液透析滤过治疗及针对性护理,治疗后观察及评价治疗及护理效果.结果:治疗后患者总胆红素(total bilirubin,TBIL)、直接胆红素(direct bilirubin,DBIL)、谷草转氨酶(aspartate transaminase,AST)、谷丙转氨酶(alanine transaminase,ALT)、凝血酶原时间(prothrombin time,PT)、活化部分凝血酶原时间(activated partial prothrombin time,APTT)及NH3分别为215.6μmol/L±53.2μmol/L、105.9μmol/L±42.3μmol/L、593.4U/L±134.5 U/L、981.8 U/L±239.4 U/L、21.8 s±4.9 s、74.3 s±34.3 s及92.1μmol/L±53.3μmol/L;治疗后患者TBIL、DBIL、AST、ALT、PT及NH3有所改善,且差异具有统计学意义(P<0.05).治疗后患者Na+、K+、Ca2+、Cl-、SCr及BUN水平分别为2.11mmol/L±0.63 mmol/L、4.19 mmol/L±1.41mmol/L、2.31 mmol/L±0.81 mmol/L、94.33mmol/L±11.94 mmol/L、168.28μmol/L±39.25μmol/L及15.49 mmol/L±3.48 mmol/L;治疗前后Na+、K+、Ca2+、Cl-水平无统计学差异(P>0.05),治疗后SCr及BUN水平有显著性改善(P<0.05).结论:血浆置换联合持续静脉血液透析滤过治疗急性肝功能衰竭患者临床效果满意,建议在临床治疗中推广应用.

AIM：To analyze the clinical efficacy of blood purification in the treatment of patients with acute liver failure and to explore the nursing strategy.METHODS：Forty-one patients with acute liver failure treated at our hospital from June 2006 to May 2013 were included.The patients received conventional treatment,plasmapheresis combined with continuous venovenous hemodiafiltration,and targeted nursing.Clinical efficacy was observed.RESULTS：Total bilirubin（TBIL）,direct bilirubin（DBIL）,aspartate transaminase（AST）,alanine transaminase（ALT）,prothrombin time（PT）,activated partial prothrombin time（APTT） and NH_3 levels after treatment were215.6 μmol/L ± 53.2 μmol/L,105.9 μmol/L± 42.3 μmol/L,593.4 U/L ± 134.5 U/L,981.8U/L ± 239.4 U/L,21.8 s ± 4.9 s,74.3 s ± 34.3 s and 92.1 μmol/L ± 53.3 μmol/L,respectively,and TBIL,DBIL,AST,ALT,PT and NH_3 levels were significantly improved after treatment（P 0.05）.Na^＋,K^＋,Ca^2＋,Cl^-,SCr and BUN levels after treatment were 2.11 mmol/L ±0.63 mmol/L,4.19 mmol/L ± 1.41 mmol/L,2.31 mmol/L ± 0.81 mmol/L,94.33 mmol/L ± 11.94 mmol/L,168.28 μmol/L ± 39.25μmol/L and 15.49 mmol/L ± 3.48 mmol/L,respectively,and only SCr and BUN levels were significantly improved after treatment（P 〈0.05）.CONCLUSION：Blood purification for treatment of patients with acute liver failure is effective.