血液净化技术救治肝功能衰竭临床疗效分析

Clinical Application and Curative Effect of Hemopurification Technology on Patients with Liver Function Failure

目的:探讨血液净化方法在抢救和治疗重型肝炎、肝性脑病、重症黄疸的作用。方法:治疗组7例患者行股静脉插管进行床边持续血液滤过、血浆置换和血液灌流,监测生命体征、血清酶学、黄疸指数、血氨、肾功能等。结果:治疗组7例神志转清6例(85.71%),肝功能指标明显改善7例(100%);对照组10例,神志转清2例(28.57%),肝功能指标明显改善1例。治疗后两组的黄疸指数、血钠、血氨改变均有明显差异。对照组死亡8例,治疗组死亡仅1例。结论:血液净化治疗重症肝炎、重症黄疸、肝性脑病疗效肯定,尤其是近期疗效。能显著提高肝功能衰竭患者的存活率。建议在肝功能衰竭诊断明确后尽早采用。

Purpose:To investigate the clinical application and curative effect of hemopurification on patients with severe hepatitis and hepatic encefalopathy or severe icterus. Methods: Total of 17 cases were randomly divided into two groups; therapeutic group ( n =7) were indwelt through femoral vein to set up vascular access undergoing continuous hemofiltration combined plasma exchange or hemoperfusion; control group( n = 10) were switched on conventional therapy. The levels of serum enzymology\icterus indexed,blood ammonia,renal function indexes (blood urea nitrogen, serum, creatinine) were examined before and after treatment in therapeutic group and control group. The physical signs were minitored and the complaints were recorded during hemopurification treatment. Results;In therapeutic group, 6 cases were recovered their consciousness(6/7,85. 7% ) ,6 cases survived, and the liver indexes were all improved(7/7,100% ). But in control group,2 cases were recovered their consciousness(2/10, 28. 5% ) ,only 1 case survived, and liver indexes improved. There were significant differences between both groups in liver indexes and survival rate. The levels of blood icterus indexes, blood urea nitrogen, serum creatinine, serum ammonia in therapeutic group were lower than those in control group, there were significant differences between two groups. Conclusion; If hemopurification technology performed earlier to treat the patients with severe hepatitis and icterus or hepatic encephalopathy, the therapeutic effect would be markedly improved, including the survival and outcome, especially to improve the survival of patients with liver function failure.