PDF与PE和DPMAS治疗急性肝衰竭的临床疗效对比分析

Comparative Analysis of Clinical Efficacy of PDF,PE and DPMAS in the Treatment of Acute Liver Failure

目的探讨在对急性肝衰竭进行治疗时使用PDF与PE和DPMAS治疗的效果。方法回顾性分析2017年1月—2018年12月该院收治的216例急性肝衰竭患者,对患者进行数字法随机抽取,各抽取72例,设为PDF组(血浆透析滤过)、PE组(血浆置换)和DPMAS组(双重血浆分子吸附系统)。分析3组的治疗效果,治疗前后TBIL、DBIL、ALT、PTA和CRP水平,以及不良反应。结果PDF的治疗效果81.94%明显提高,且有效改善TBIL(93.23±8.28)μmol/L、DBIL(34.91±10.56)μmol/L、ALT(221.79±30.75)U/L、PTA(64.97±13.07)%和CRP(38.33±9.82)mg/L水平,治疗后PDF组TBIL、DBIL、ALT、PTA和CRP水平优于DPMAS组和PE组(t=19.792、19.937、13.858、13.148、20.446、20.392、5.687、5.982、15.334、15.924,P<0.05),DPMAS组和PE组TBIL、DBIL、ALT、PTA和CRP水平差异无统计学意义(P>0.05),3组不良反应均差异无统计学意义(P>0.05)。结论对急性肝衰竭进行治疗时使用PDF治疗,治疗效果明显,且有效提高患者的肝功能,安全可靠,因此具有临床应用的价值。

Objective To explore the effect of using PDF,PE and DPMAS in the treatment of acute liver failure.Methods A retrospective analysis of 216 patients with acute liver failure admitted to our hospital from January 2017 to December 2018 was randomly selected by the digital method,and 72 patients were randomly selected.They were set as PDF group(plasma diafiltration)and PE group(Plasma exchange)and DPMAS group(dual plasma molecular adsorption system).Analyze the treatment effect of the three groups,TBIL,DBIL,ALT,PTA and CRP levels before and after treatment,as well as adverse reactions.Results The therapeutic effect of PDF was obviously improved by 81.94%,and effectively improved TBIL(93.23±8.28)μmol/L,DBIL(34.91±10.56)μmol/L,ALT(221.79±30.75)U/L,PTA(64.97±13.07)%and CRP(38.33±9.82)mg/L level,the TBIL,DBIL,ALT,PTA and CRP levels of the PDF group after treatment were better than those of the DPMAS group and the PE group(t=19.792,19.937,13.858,13.148,20.446,20.392,5.687,5.982,15.334,15.924,P<0.05),there was no statistically significant difference in the levels of TBIL,DBIL,ALT,PTA and CRP in the DPMAS group and the PE group(P>0.05),and there was statistically no significant difference in adverse reactions in the three groups(P>0.05).Conclusion The use of PDF in the treatment of acute liver failure has obvious therapeutic effect,and effectively improves the liver function of patients.It is safe and reliable,so it has the value of clinical application.