分子吸附循环系统(MARS人工肝)在肝移植围手术期应用的临床研究

The clinical study on applying molecular adsorbent recycling system(MARS) in perioperative period with orthotopic liver transplantation(OLT)

目的 总结肝移植围手术期应用分子吸附循环系统 (MARS人工肝 )的经验。方法 回顾分析 19例 4 8次MARS人工肝治疗的疗效。结果 单次 6h(或多次 )MARS人工肝治疗能显著降低血清总胆红素、间接胆红素、血氨、尿素氮、肌苷、尿酸等水平 ,其中 15例病人成功过渡到肝移植 ,l例晚期肝硬化病人经人工肝治疗后肝性脑病症状得到缓解 ,因各种原因不愿再行肝移植 ,出院后 2周死亡 ,另 1例患者因上消化道大出血未能等到肝移植而死亡。 2例肝移植术后患者 ,治疗后好转出院。治疗成功率为 88.9%。结论 MARS人工肝分子吸附循环系统是治疗肝功能衰竭安全而有效的辅助方法 ,为过渡到肝移植创造了机会。

Objective:To summerize the experiences of using molecular adsorbent recycling system(MARS) in perioperative period with orthotopic liver transplantation(OLT).Methods: To analyse curative effect of MARS-artificial liver treatments on 19 cases (48 times).Results:The levels of serum total bilimbin, BUN, Cr, uring acid and blood ammonia were greatly reduced by using MARS. 16 patients were bridged to transplantation, 1 patient was relieved in sympotoms of hepatic encephalopathy after MARS treatment, died 2 weeks after leaving hospital, 1 patient died of severe gastro-intestinal bleeding before transplantation. 2 posttransplant patients were relieved after assisted by MARS. The survival rate was 88.9%.Conclusions: MARS artificial liver now is a safe and effective assist methode to treat liver failure. It can help to gain more chances for undergoing OLT for the patients.