摘要
目的分析高压氧辅助治疗对慢性肝衰竭患者临床疗效及疲劳程度的影响。方法回顾性分析空军军医大学第一附属医院2021年5月至2023年7月收治的107例慢性肝衰竭患者的病历资料,按治疗方法不同分成对照组(常规西医治疗)52例和观察组(高压氧联合常规西医治疗)55例。比较2组患者的腹水疗效、肝功能、终末期肝病模型联合血清钠(MELD-Na)评分、内毒素(ET)、凝血酶原活动度(PTA)、外周血炎症信号通路、疲劳程度及不良反应。结果观察组腹水治疗总有效率(90.91%,50/55)高于对照组(71.15%,37/52),差异有统计学意义(χ^(2)=6.864,P=0.009)。治疗后,2组碱性磷酸酶(ALP)、总胆红素(TBIL)、丙氨酸氨基转移酶(ALT)、ET水平及MELD-Na评分均降低,且观察组低于对照组,差异均有统计学意义(均P<0.05);2组患者PTA高于治疗前,且观察组高于对照组,差异均有统计学意义(均P<0.05);2组核转录因子-κB(NF-κB)mRNA、Toll样受体4(TLR4)mRNA水平均降低,且观察组低于对照组,差异均有统计学意义(均P<0.05)。治疗后,观察组和对照组多维疲劳量表(MFI-20)、疲劳严重程度量表(FSS)评分分别为(45.03±4.10)、(27.12±2.56)分和(60.13±5.16)、(39.36±3.25)分,均低于治疗前,且观察组低于对照组,差异均有统计学意义(均P<0.05)。2组患者总不良反应发生率比较差异无统计学意义(P>0.05)。结论高压氧辅助治疗慢性肝衰竭疗效确切,可改善患者肝功能与预后,减轻炎症反应与疲劳程度,且安全性良好。
Objective:To analyze the efficacy of hyperbaric oxygen(HBO)adjuvant therapy in patients with chronic liver failure(CLF)and its effects on fatigue levels.Methods:A retrospective analysis was conducted on the medical records of 107 CLF patients admitted to the First Affiliated Hospital of Air Force Medical University from May 2021 to July 2023.The patients were divided into a control group(52 cases,receiving conventional Western medicine treatment)and an observation group(55 cases,receiving HBO combined with conventional western medicine treatment).The efficacy of ascites treatment,liver function,Model for End-Stage Liver Disease combined with serum sodium(MELD-Na)score,endotoxin(ET),prothrombin activity(PTA),peripheral blood inflammatory signaling pathways,fatigue levels,and adverse reactions were compared between the two groups.Results:The total effective rate of ascites treatment in the observation group(90.91%,50/55)was significantly higher than that in the control group(71.15%,37/52)(χ^(2)=6.864,P=0.009).After treatment,levels of alkaline phosphatase(ALP),total bilirubin(TBIL),alanine aminotransferase(ALT),ET,and MELD-Na scores decreased in both groups,with the observation group showing lower levels than the control group(all P<0.05);PTA increased in both groups,with the observation group showing higher levels than the control group after treatment(all P<0.05);levels of nuclear factor-kappa B(NF-κB)mRNA and Toll-like receptor 4(TLR4)mRNA decreased in both groups,with the observation group showing lower levels than the control group(all P<0.05).Post-treatment scores of the multidimensional fatigue inventory(MFI-20)and fatigue severity scale(FSS)were[(45.03±4.10)and(27.12±2.56)points]in the observation group,and were[(60.13±5.16)and(39.36±3.25)points]in the control group,respectively,all lower than pre-treatment levels,with the observation group showing lower scores than the control group(all P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion:HBO adjuvant therapy is effective in treating CLF,which can improve liver function and prognosis,reduce inflammatory responses and fatigue levels,and demonstrate good safety.
作者
王珍
张静
杨艳
Wang Zhen;Zhang Jing;Yang Yan(Department of Gastroenterology,The First Afiliated Hospital of Air Force Medical University,Xi'an 710032,China)
出处
《中华航海医学与高气压医学杂志》
2025年第7期715-719,共5页
Chinese Journal of Nautical Medicine and Hyperbaric Medicine
基金
国家自然科学基金资助项目(81402467)。
关键词
慢性肝衰竭
高压氧
疲劳
不良反应
Chronic liver failure
Hyperbaric oxygen
Fatigue
Adverse reaction
