病毒灭活血浆与普通冰冻血浆在慢加急性肝衰竭患者血浆置换中的应用效果

Application effect of virus-inactivated plasma and ordinary frozen plasma in plasma exchange in patients with chronic and acute liver failure

目的探讨病毒灭活血浆与普通冰冻血浆在慢加急性肝衰竭患者治疗中血浆置换的应用效果。方法前瞻性选取68例2018年1月至2020年12月在百色市辖区右江民族医学院附属医院和百色市人民医院收治的慢加急性肝衰竭患者作为研究对象,按照随机数字表法将所选患者分为对照组(n=34)与试验组(n=34)。对照组给予普通冰冻血浆进行治疗,试验组给予病毒灭活血浆进行治疗,两组均持续治疗1个月。比较两组治疗后的临床疗效、治疗前后的凝血指标、生物化学检测指标及治疗期间的不良反应发生率。结果治疗后,试验组总有效率(79.41%)与对照组(70.59%)比较,差异无统计学意义(P>0.05)。治疗前后,两组血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)水平比较,差异均无统计学意义(P>0.05)。与治疗前比较,治疗后试验组血清C反应蛋白(CRP)水平降低,且低于对照组(P<0.05)。与治疗前比较,治疗后,两组血清直接胆红素(DBIL)、总胆红素(TBIL)水平均降低,但组间比较,差异均无统计学意义(P>0.05)。治疗期间,试验组不良反应发生率为8.82%,低于对照组的29.41%(P<0.05)。结论病毒灭活血浆与普通冰冻血浆用于慢加急性肝衰竭患者血浆置换中的应用效果差别不显著,但相比普通冰冻血浆,病毒灭活血浆的安全性更高。

Objective To explore the application effect of virus-inactivated plasma and ordinary frozen plasma in plasma exchange in patients with chronic and acute liver failure.Methods A total of 68 patients with chronic and acute liver failure admitted to the Affiliated Hospital of Youjiang Medical University for Nationalities and Baise People's Hospital from January 2018 to December 2020 were selected prospectively.They were divided into the control group(n=34)and the experimental group(n=34)using random number table method.The control group were treated with ordinary frozen plasma,and the experimental group were treated with virus-inactivated plasma.Both groups were treated for 1 month.The clinical efficacy,coagulation indexes,and biochemical indexes before and after treatment,and the incidence of adverse events during treatment were compared between the two groups.Results After treatment,the total effective rate of the experimental group(79.41%)was higher than that of the control group(70.59%),without statistically significant difference(P>0.05).There was no significant differences in plasma prothrombin time(PT),activated partial thromboplastin time(APTT),and fibrinogen(FIB)levels between the two groups before and after treatment(P>0.05).The level of serum C-reactive protein(CRP)in the experimental group was decreased after treatment and was lower than that in the control group(P<0.05).The levels of serum direct bilirubin(DBIL)and total bilirubin(TBIL)in both groups were decreased after treatment,and there were no statistically significant differences between the two groups(P>0.05).The incidence of adverse events in the experimental group(8.82%)was lower than that in the control group(29.41%)during treatment(P<0.05).Conclusion There is little difference in the application effect of virus-inactivated plasma and ordinary frozen plasma in plasma exchange in patients with chronic and acute liver failure.Virus-inactivated plasma is safer than ordinary frozen plasma.