血浆置换治疗肝功能衰竭的疗效评价

Clinical research of patients with liver failure treated with plasma exchange

目的 总结血浆置换型人工肝治疗11例肝功能衰竭的临床疗效。方法 11例肝功能衰竭病人采用血浆置换治疗(治疗组),9例为常规药物治疗(对照组),观察血浆置换对肝功能恢复的影响,并分析其疗效。结果 血浆置换后患者血清总胆红素(TBIL)明显下降(210±86μmol/L VS 342±96μmol/L,P<0.05);凝血酶原时间缩短(26±12s VS 38±11s,P<0.05),但治疗前后血清谷丙转氨酶(ALT)变化不显著(852±221U/L VS 795±195U/L,P>0.05)。血浆置换组存活7例,存活率为63.6％(7/11);高于对照组的37.5％(3/9,P<0.05)。结论 血浆置换治疗肝功能衰竭可明显降低血清TBIL、缩短凝血酶时间,并可提高患者生存率,是目前治疗肝功能衰竭的重要手段之一。

Objective To summarize the efficacy of plasma exchange in 11 patients with liver failure. Methods Eleven patients with liver failure were treated with plasma exchange (treatment group) , nine patients were treated with routine drugs (control group) .The efficacy of the plasma exchange was observed. Results The serum total bilirubin(TBIL) decreased greatly after the plasma exchange(210 ± 86 μmol/L vs 342 ± 96 μmol/L, P < 0.05) ,and prothrombin time shortened (26 ± 12 s vs38±11 s, P < 0.05) in the treatment group, while the serum aminotransferase( ALT) had no significant changes (852 ± 221 U/L vs 795 ± 195 U/L, P > 0.05) The survival rate in the treatment group was higher than that in the control group (63.6% vs 33.3% , P < 0.05) .Conclusions Plasma exchange can significantly decrease serum TBIL,shorten prothrombin time, and improve the survival rate of patients with liver failure. At present, plasma exchange is one of the important therapy for the patients with liver failure.