摘要
目的 :探讨非生物型人工肝支持疗法血浆置换 (PE)与高通量血液透析滤过 (HDF)相结合对国内重症肝炎肝脏衰竭的临床疗效、安全性及可行性。方法 :对 2 6例不同病因重症肝炎肝衰竭患者应用上述人工肝方法进行治疗 5 8次 ,通过比较治疗前后患者临床症状、肝功能、凝血酶原活动度 (PTA)、血氨等指标判断临床疗效 ,观察治疗相关的不良反应及患者耐受情况判断安全性及可行性。结果 :患者意识、黄疸、乏力、腹胀、纳差等症状均明显缓解 ,血清总胆红素治疗后较治疗前平均降低 (190 .8± 93.6 )μmol/L ,PTA上升 (19.7± 8.9) % ,治疗后存活率达 80 .8% ,不良反应主要以血浆过敏居多 ,未发生大出血、休克等严重并发症及应用血制品引起的重叠感染 ,患者耐受良好。结论 :PE联合 HDF可显著改善重症肝炎肝脏功能衰竭患者临床症状及生化指标 ,提高近期存活率 ,且安全可行 ,值得在国内推广使用。
Objective:To determine the feasibility,security and clinical effects of the combination of plasma exchange(PE) and highflow hemodiafiltration(HDF) in the treatment of liver failure caused by severe hepatitis. Methods:Fiftyeight treatments with combined therapy were taken in 26 patients with severe hepatitis. The changes of clinical symptom,liver function,plasma thrombinogen activity and ammonia were observed to determine the clinical effects.The feasibility and security were determined by therapy related adverse reactions and tolerance of the patients.Results:After the treatment,the clinical symptoms such as conscious disturbance, jaundice,inertia,abdominal distention were taken better turn.The serum bilirubin decreased 〔(190 8±93 6)μmol/L〕 and PTA increased 〔(19 7±8 9)%〕.the major adverse reaction was hypersensitive to plasma ,no severe hemorrhage,shock and superinfection happened.All patients tolerated the combined therapy. Conclusion: The combined therapy is a safe treatment and can significantly improve the symptoms, blood parameters and recently mortality in hepatic failure patients with severe hepatitis.The therapy is worth to spread.
出处
《中国危重病急救医学》
CAS
CSCD
2003年第2期103-105,共3页
Chinese Critical Care Medicine
基金
浙江省瑞安市科技发展计划项目 (2 0 0 2 43 12 3 )
关键词
重症肝炎
肝脏衰竭
人工肝
血浆置换
血液透析滤过
治疗
severe hepatitis
liver failure
artificial liver
plasma exchange
hemodiafiltration
treatment
