人工肝治疗终末期肝病肝衰竭的终末期肝病模型预后分析

Analysis of prognosis on patients with end-stage liver disease treated with artificial liver support system using the criterion of model for end-stage liver disease

目的 通过观察应用终末期肝病模型 (MELD)对人工肝治疗终末期肝病预后的预测作用 ,探讨其在临床的应用价值及人工肝支持系统在终末期肝病治疗中的效果。方法 43例患者随机分为治疗组与对照组 ,对其进行MELD评分 ,并对治疗组进行人工肝后评分 ,观察 3个月后的死亡率。结果 治疗组中 4例治疗前MELD评分大于 40分者 ,3个月死亡率为 10 0 %,17例治疗前评分 30～ 40分者 3个月死亡率为 5 3%,对照组中 6例MELD评分大于 40分者 ,3个月死亡率为 10 0 %,16例治疗前评分 30～ 40分者 3个月死亡率为87%,与治疗组相比P <0 .0 5。结论 MELD评分可以引入临床推广应用 ,人工肝治疗MELD评分在 30～ 40分的终末期肝病是安全有效的。

objective To study the practical use of model for end-stage liver disease(MELD)on clinic and the role of artificial liver support system (ALSS)on end-stage liver disease. Methods Fourty-three patients were divided randomly into treatment group and control group, and they were graded with MELD before and after ALSS. The death rate was observed three months later. Results In the treatment group,4 cases with MELD score higher than 40 before treatment of ALSS were all dead after 3 months, and 17 cases with MELD score between 30 and 40 remained a death rate of 53%;In the control group,6 cases with MELD score higher than 40 were all dead too, and the death rate of 16 cases with MELD score between 30 and 40 was 87% 3 months later; There were significant difference compared with the treatment group, (P<0.05).Conclusions MELD can be popularized in clinic and ALSS can be used safely and effectively to treat end-stage liver disease with MELD score between 30 and 40.