不同类型非生物型人工肝治疗肝衰竭合并肝性脑病的效果

The effect of different types of non biological artificial liver in the treatment of liver failure combined with hepatic encephalopathy

目的分析不同类型非生物型人工肝治疗肝衰竭合并肝性脑病的效果。方法选取2021年1月至2023年6月九江市第三人民医院收治的112例肝衰竭合并肝性脑病患者作为研究对象,按照随机数字表法分为对照组与观察组,每组56例。对照组行血浆置换,观察组行血浆置换联合血液透析。比较两组治疗前后临床肝功能指标[总胆红素(TBIL)、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、总胆汁酸(TBA)、凝血酶原活动度(PTA)、血氨、白蛋白(ALB)]、临床疗效、不良反应发生情况。结果治疗后,观察组TBIL、AST、ALT、血氨水平均低于对照组,PTA、ALB水平均高于对照组,差异有统计学意义(P<0.05)。观察组TBIL、TBA清除率均明显高于对照组,差异有统计学意义(P<0.05)。观察组治疗总有效率为73.21%,高于对照组的53.57%,差异有统计学意义(P<0.05)。结论与单独血浆置换相比,血浆置换联合血液透析治疗肝衰竭合并肝性脑病的效果更好,能彻底清除患者血液中的中小分子,提高TBIL和TBA清除率,提升凝血酶原活动度,降低血氨水平,减轻肝性脑病临床症状,延长患者的生存期。

Objective To analyze the effect of different types of non biological artificial liver in the treatment of liver failure combined with hepatic encephalopathy.Methods 112 patients with liver failure combined with hepatic encephalopathy admitted to the Third People's Hospital of Jiujiang City from January 2021 to June 2023 were selected as the study subjects,and they were divided into the control group and the observation group according to the random number table method,with 56 cases in each group.The control group underwent plasma exchange,while the observation group underwent plasma exchange combined with hemodialysis.The clinical liver function indicators between two groups(total bilirubin[TBIL],aspartate aminotransferase[AST],alanine aminotransferase[ALT],total bile acid[TBA],prothrombin activity[PTA],blood ammonia,albumin[ALB])before and after treatment,and clinical efficacy,the occurrence of adverse reactions were compared between the two groups.Results After treatment,the levels of TBIL,AST,ALT and blood ammonia in the observation group were lower than those in the control group,and the levels of PTA and ALB were higher than those in the control group,the differences were statistically significant(P<0.05).The clearance rates of TBIL and TBA in the observation group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).The total effective rate of treatment in the observation group was 73.21%,which was higher than 53.57%in the control group,and the difference was statistically significant(P<0.05).Conclusion Compared with plasma exchange alone,plasma exchange combined with hemodialysis is more effective in treating liver failure complicated with hepatic encephalopathy,it can completely eliminate small and medium-sized molecules in the patients'blood,improve the clearance rates of TBIL and TBA,enhance prothrombin activity,reduce blood ammonia levels,alleviate clinical symptoms of hepatic encephalopathy,and prolong the patients'survival.