双重血浆分子吸附系统联合半量血浆置换治疗肝衰竭两种预冲方法的比较

Comparison of two preflushing methods of double plasma molecular absorb system combined with half-dose plasmapheresis with optimized preflush process in the treatment of liver failure

目的探讨优化预冲流程的双重血浆分子吸附系统(DPMAS)联合半量血浆置换治疗肝衰竭的疗效及安全性。方法纳入2018年1月-2019年12月我中心收治的100例采取DPMAS联合半量血浆置换治疗的肝衰竭患者,按照不同预冲方法随机分为观察组(优化预冲方法)和对照组(传统预冲方法)各50例,比较2组的疗效及安全性。结果2组患者均完成DPMAS联合半量血浆置换治疗,比较2组治疗后的肝功能、凝血功能、血常规及血浆氨等各项实验室指标,差异无统计学意义(P>0.05)。2组发生堵管、提前下机及不良反应的情况比较,差异无统计学意义(P>0.05)。观察组的操作步骤更少,其操作时间及操作失误率均明显低于对照组(P<0.05)。结论优化预冲流程的DPMAS联合半量血浆置换治疗肝衰竭,不仅能有效改善患者的肝功能及血氨,还因其操作更为简便、省时、失误率少,较传统预冲流程具有更高的护理安全性,值得临床推广。

Objective To explore the efficacy of double plasma molecular absorb system(DPMAS)combined with half amount of plasma exchange with optimized preflush process in the treatment of liver failure and its safety.Methods A total of 100 patients with liver failure treated with DPMAS combined with half-dose plasmapheresis in our hospital from January 2018 to December 2019 were enrolled.They were randomly divided into observation group(optimized preflushing group)and control group(traditional preflushing group)according to different preflushing process(50 patients for each group),and the efficacy and safety of them were compared.Results DPMAS combined with half-volume plasmapheresis treatment was all completed in patients of both groups.There was no significant difference in liver function,coagulation function,blood routine,plasma ammonia and other laboratory indexes between the two groups after treatment(P>0.05).And there was no statistically significant difference in the occurrence of pipe blockage,machine disembark in advance,and adverse reactions between the two groups(P>0.05).The observation group had significantly fewer operation steps,and lower operation time and operation error rate than the control group(P<0.05).Conclusions DPMAS combined with half volume plasmapheresis with optimized prepunch process to treat patients with liver failure cannot only effectively improve the liver function and plasma ammonia,but also have higher nursing safety than the traditional preflush process,due to its simpler operation,less time saving,and less error rate.Therefore,it is worthy of clinical promotion.