胆红素吸附治疗高胆红素血症的疗效分析

Observation and analysis of bilirubin adsorption in patients with hyperbilirubinemia

目的观察高胆红素血症患者行胆红素吸附治疗的临床疗效。方法选取2015—2017年在中南大学湘雅医院血液净化中心行胆红素吸附治疗的高胆红素血症患者,共10例。其中,男性8例,女性2例;平均年龄(57±18)岁。结果 10例患者共行18次胆红素吸附治疗,其中显效1例,有效8例,无效2例,总有效率为80%。治疗后胆红素降低(P <0.05),对转氨酶、肌酐、尿素、尿酸的清除无作用(P>0.05),对白蛋白、血常规、凝血常规、E7A无影响(P>0.05)。结论胆红素吸附在治疗以血清胆红素升高为主的高胆红素血症患者效果较好,安全性高。若合并有自发性腹膜炎、肝肾综合征、肝性脑病等并发症的危重患者,则应联合多种人工肝治疗模式。

Objective To evaluate the clinical efficacy of bilirubin adsorption in patients with hyperbilirubinemia.Methods A total of 10 patients with hyperbilirubinemia who underwent bilirubin adsorption therapy at the Blood Purification Center of Xiangya Hospital,Central South University from 2015 to 2017 were enrolled.Among them,8 were male and 2 were female;the average age was(57±18)years.Results A total of 18 bilirubin treatments were performed in 10 patients.Among them,1 was markedly effective,8 was effective,and 2 were ineffective.The total effective rate was 80%.After treatment,bilirubin decreased (P<0.05),which had no effect on the clearance of transaminase,creatinine,urea,uric acid (P >0.05),and had no effect on albumin,blood routine,coagulation routine,E7A(P >0.05).Conclusions The bilirubin adsorption is effective and safe in the treatment of hyperbilirubinemia patients with elevated serum bilirubin.If a critically ill patient with complications such as spontaneous peritonitis,hepatorenal syndrome,or hepatic encephalopathy is combined,multiple artificial liver treatment modes should be combined.