人工肝治疗激素部分应答的肝衰竭前期患者的临床研究

Clinical study of artificial extracorporeal liver in treatment of pre-hepatic failure patients with partial hormone response

目的研究人工肝治疗激素部分应答的肝衰竭前期患者的临床疗效。方法82例糖皮质激素部分应答的肝衰竭前期患者,根据后续治疗方法不同分为常规组和研究组,各41例。常规组患者继续实施激素治疗,研究组患者使用人工肝支持治疗。比较两组患者临床疗效、治疗前后肝功能指标改善情况及治疗3个月后存活率。结果研究组患者治疗总有效率为87.8%,常规组患者治疗总有效率为53.7%,研究组治疗总有效率明显高于常规组,差异有统计学意义(P<0.05)。治疗前,两组患者总胆红素(TBIL)、谷草转氨酶(AST)、谷丙转氨酶(ALT)、白蛋白(Alb)、凝血酶原时间(PT)指标比较,差异无统计学意义(P>0.05);治疗后,研究组患者TBIL、ALT、AST、Alb、PT指标均明显优于常规组,差异具有统计学意义(P<0.05)。治疗3个月后,研究组患者存活35例,存活率为85.4%;常规组患者存活17例,存活率为41.5%。研究组患者存活率明显高于常规组,差异具有统计学意义(P<0.05)。结论针对激素部分应答的肝衰竭前期患者实施人工肝治疗,其临床疗效明显,可明显改善患者肝功能,显著提高生存率,值得临床推广与应用。

Objective To study the clinical efficacy of artificial extracorporeal liver in treatment of prehepatic failure patients with partial hormone response.Methods A total of 82 pre-hepatic failure patients with partial hormone response were divided by different follow-up treatment into conventional group and research group,with 41 cases in each group.The conventional group received hormone therapy,and the research group received artificial extracorporeal liver support therapy.The clinical efficacy,improvement of liver function indexes before and after treatment and survival rate after 3 months of treatment were compared between the two groups.Results The total effective rate of treatment was 87.8%in the research group,which was 53.7%in the conventional group,and the total effective rate of treatment in the research group was obviously higher than that in the conventional group.Their difference was statistically significant(P<0.05).Before treatment,there was no statistically significant difference in total bilirubin(TBIL),aspartate aminotransferase(AST),alanine aminotransferase(ALT),albumin(Alb),prothrombin time(PT)between the two groups(P>0.05).After treatment,the levels of TBIL,ALT,AST,Alb and PT in the research group were obviously better than those in the conventional group,and their difference was statistically significant(P<0.05).After 3 months of treatment,the research group had 35 survived cases,accounting for 85.4%,and the research group had 17 survived cases,accounting for 41.5%.The survival rate in the research group was obviously higher than that in the conventional group,and the difference was statistically significant(P<0.05).Conclusion Artificial extracorporeal liver therapy shows obvious clinical efficacy for pre-hepatic failure patients with partial hormone response,and it can obviously improve the liver function of patients and significantly improve survival rate.It is worthy of clinical promotion and application.