血液灌流对急性肝衰竭后肝纤维化进展影响的临床观察

Clinical observation on the influence of hemoperfusion on liver fibrosis secondary to acute liver failure

目的探讨血液灌流治疗后肝衰竭患者肝纤维化进展情况。方法选取2012年3月—2015年9月在本院住院的37例急性肝衰竭患者,根据不同治疗方案分为治疗组和对照组,治疗组14例患者在内科治疗基础上联合血液灌流治疗,对照组23例患者只采用内科治疗,分别予治疗2~4周,比较治疗前后生化指标、凝血功能及肝纤维化指标变化,随访1年间两组患者肝纤维化指标进展情况。计量资料采用t检验,计数资料采用χ~2检验,P〈0.05为差异有统计学意义。结果治疗组住院时间低于对照组,两组患者治疗后TBil、IBil、ALT均明显下降,血小板明显改善,随访过程中,治疗组肝纤维化指标上升速度低于对照组,对比差异均有统计学意义（均P〈0.05）。治疗组和对照组复发比例分别为21.4%、30.4%,复发比例对比差异有统计学意义（P〈0.05）。结论血液灌流治疗有助于延缓急性肝衰竭后肝纤维化进展。

Objective To explore progression of liver fibrosis secondary to acute liver failure received therapy of hemoperfusion.Methods 37 patients of acute liver failure were devided into two groups according to different treat model from March 2012 to September 2015.14 patients in the control group were treated with conventional medicine only,23 patients in the treat group were treated with hemoperfusion besides for conventional medicine.Biochemistry items coagulation factors and serum bilirubin were compared in both groups between pro-therapy and post-therapy.Liver fibrosis factors were tested during the one year＇s follow-up.Measurement data was processed by t test,count data was processed by chi sqare test,the result of P0.05 was considered statistically significant.Results The length of stay in hospital of treat group was signficantlly slowly than control group,level of TBil,IBil and ALT decreased significantly in both treat models after therapy,and blood platelet counts improved significantly,liver fibrosis factors in the treat group deteriorated less slowly than control group（all P0.05）.20.4% patients in the therapy group and 30.4%patients in the control were observed relapsing,differences significant（P0.05）.Conclusion Hemoperfusion can help to slower deterioration of liver fibrosis factors in patients of acute liver failure.