人工肝胆红素特异性吸附治疗对高胆红素血症患者的临床疗效总结以及护理体会

The clinical therapeutic effect and nursing experience of using artificial liver bilirubin specific adsorption for treatment of patients with hyperbilirubinemia

目的 观察人工肝胆红素特异性吸附治疗高胆红素血症患者的疗效以及护理对其的影响.方法 采用前瞻性研究方法.选择2015年1月至2016年12月绵阳市中心医院收治的146例高胆红素血症患者,将患者按随机数字表法分为观察组77例和对照组69例.观察组在内科常规治疗基础上行人工肝胆红素特异性吸附治疗,对照组仅进行内科常规治疗.观察两组治疗后肝功能指标丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、总胆红素（TBil）、直接胆红素（DBil）水平的变化及临床疗效.结果 两组治疗前ALT、AST、TBil、DBil比较差异均无统计学意义（均P〉0.05）,治疗后上述指标均较治疗前明显降低,且以观察组的降低程度较对照组更加显著〔ALT（U/L）：341±42比455±37,AST（U/L）：120±35比197±37,TBil（μmol/L）：185.4±20.6比302.6±30.6,DBil（μmol/L）：42.6±10.8比87.5±11.6,均P〈0.05〕,观察组总有效率明显高于对照组〔62.3%（48/77）比40.6%（28/69）,P〈0.05〕.结论 在保肝、对症支持治疗基础上配合人工肝胆红素特异性吸附治疗高胆红素血症患者安全、有效,密切观察与精心护理有利于减少并发症的发生,提高治疗有效率.

Objective To observe the curative effect of using artificial liver bilirubin specific adsorption for treatment of patients with hyperbilirubinemia and its effect on nursing.Methods A prospective study was conducted, 146 patients with hyperbilirubinemia admitted to Mianyang Central Hospital from January 2015 to December 2016 were enrolled, and they were divided into an observation group （77 cases） and a control group （69 cases） according to random number table method. The observation group was treated by medical treatment and the artificial specific liver bilirubin adsorption, while the control group only treated by medical therapy. The changes of levels of liver function indexes alanine aminotransferase （ALT）, aspartate aminotransferase （AST）, total bilirubin （TBil）, direct bilirubin （DBil） before and after treatment and clinical curative effect were observed in the two groups.Results Before treatment, there were no statistical significant differences in levels of the ALT, AST, TBil, DBil between the two groups （allP 〉 0.05）, after treatment, the above indexes were significantly decreased compared to those before treatment, and the degrees of decrease in observation group were more obvious than those in control group [ALT （U/L）： 341±42 vs. 455±37, AST （U/L）： 120±35 vs. 197±37, TBil （μmol/L）： 185.4±20.6 vs. 302.6±30.6, DBil （μmol/L）： 42.6±10.8 vs. 87.5±11.6, allP 〈 0.05]. The total effective rate in observation group was obviously higher than that of control group [62.3% （48/77） vs. 40.6% （28/69）,P 〈 0.05].Conclusions Based on liver protection, symptomatic and supportive medical treatment, using artificial liver bilirubin specific adsorption for treatment of patients with hyperbilirubinemia is safe and effective, and in addition, close observation and careful nursing is beneficial to the reduction of incidence of complications and elevation of therapeutic efficiency.