人工肝血液净化技术治疗肝衰竭患者的近期疗效及其影响因素

Short-term efficacy and influencing factors of artificial liver blood purification technology in treatment of patients with liver failure

目的:探讨人工肝血液净化技术治疗肝衰竭患者的近期疗效及其影响因素。方法:回顾性分析2019年1月至2021年12月于周口市中心医院行人工肝血液净化技术治疗的113例肝衰竭患者的临床资料,评估人工肝血液净化技术治疗肝衰竭患者的近期疗效,并对影响疗效的相关因素进行单因素和多因素Logistic回归分析。结果:113例肝衰竭患者经人工肝血液净化治疗后,临床好转70例(61.95%),临床恶化43例(38.05%);临床好转者与临床恶化者的性别、病毒性肝炎、腹水、合并感染、人工肝血液净化技术治疗次数,以及凝血酶原活动度、血红蛋白、血钾水平比较,差异均无统计学意义(P>0.05);临床好转者与临床恶化者的年龄、入院途径、入住病房、肝衰竭分型、肝性脑病占比和血清总胆红素、白蛋白水平比较,差异均有统计学意义(P<0.05);多因素Logistic回归分析结果显示,年龄大、急性肝衰竭、血清总胆红素水平高、白蛋白水平低是人工肝血液净化技术治疗肝衰竭患者近期疗效差的独立危险因素(OR>1,P<0.05)。结论:年龄大、急性肝衰竭、血清总胆红素水平高、白蛋白水平低是人工肝血液净化技术治疗肝衰竭患者近期疗效差的独立危险因素。

Objective:To investigate short-term efficacy and influencing factors of artificial liver blood purification technology in treatment of patients with liver failure.Methods:The clinical data of 113 patients with liver failure who underwent artificial liver blood purification in Zhoukou central hospital from January 2019 to December 2021 were retrospectively analyzed.The short-term efficacy of artificial liver blood purification technology in the treatment of the patients with liver failure was evaluated and statistically analyzed.Univariate and multivariate Logistic regression analysis were used to analyze the influencing factors.Results:In the 113 patients with liver failure who underwent artificial liver blood purification,70 cases were clinically improved(61.95%),and 43 cases were clinically worsened(38.05%).There was no statistically significant difference in gender,viral hepatitis,ascites,combined infections,frequency of treatment with artificial liver blood purification technology,and levels of prothrombin activity,hemoglobin,and blood potassium among the patients with clinical improvement and those with clinical deterioration(P>0.05).There were significant differences in age,admission route,admission ward,liver failure classification,proportion of hepatic encephalopathy,and serum total bilirubin and albumin levels among the patients with clinical improvement and the patients with clinical deterioration(P<0.05).Multivariate logistic regression analysis showed that older age,liver failure classification,increased serum total bilirubin level,and decreased albumin level were independent risk factors for clinical deterioration of the patients with liver failure treated by artificial liver blood purification technology in the near future(OR>1,P<0.05).Conclusions:Older age,Liver failure classification,increased serum total bilirubin level and decreased albumin level are the independent risk factors for clinical deterioration of the patients with liver failure treated by artificial liver blood purification technology in the near future.