Objective To retrospectively analyze the dual plasma molecular adsorption system(DPMAS)treatment technology and the laboratory data before and after treatment in patients with liver failure and refractory hyperbilirub...Objective To retrospectively analyze the dual plasma molecular adsorption system(DPMAS)treatment technology and the laboratory data before and after treatment in patients with liver failure and refractory hyperbilirubinemia,so as to provide a clinical basis for the prediction1andpreventionof common related complicationsM.I ethods A retrospective study was conducted on 161 cases with liver failure and 683cases with refractory hyperbilirubinemia whounderwent DPMAS treatment in our department from October 2022 to July 2024.The general clinical data characteristics,DPMAS treatment status,DPMAS-related complications,and changes in important laboratory indicators before and after the initial DPMAS treatment in both patient groups were analyzed.Results Among the 229 enrolled cases,82.53%were male,and the median age was 50 years.The cause of liver failure was hepatitis B virus infection in 84.47%,while hepatitis B accounted for only 51.47%in the other group.There were significant differences in platelets,creatinine,coagulation function,and inflammatory factor-related indicators between the two groups at baseline.The total number of DPMAS treatments given was 4471 times.The proportion of albumin used in the initial stage of treatment was significantly higher inpatients with refractory hyperbilirubinemia than that in the liver failure group,while the proportion of plasma used in the liver failure group was significantly higher(P<0.001).The most commonly used anticoagulation regimen was unfractionated heparin.A combined anticoagulation therapy regimen was used in 9.3%of the refractory hyperbilirubinemia group.The internal jugular vein was selected in nearly half of the treated cases.A peripheral vascular access pathway was the treatment option in 31.2%.The proportion of centrifugal separation was significantly higher than that of membrane separation(76.22%vs.23.78%).The incidence rate of DPMAS-related complicationswas 16%.The most common complication was bleeding,including bleeding at the puncture site(accounting for 32%of the total complications)and bleeding at nonpuncture sites(12%),followed by hypotension(22%),allergic reactions(13%)and infections(11%),respectively.The indexes of hemoglobin,platelets,total bilirubin,and C-reactive protein were significantly decreased within 24-48 hours after DPMAS treatment in both groups of patients.The prothrombin time and international normalized ratio were significantly increased in theliver failure group,while fibrinogen was significantly reduced.Conclusion DPMAS clinical application is generally safe in patients with liver disease.The most common complications are bleeding hypotension,allergic reactions,and infections,which need to be paid special attention and timely intervention to ensure the safety profile of treatment.展开更多
文摘Objective To retrospectively analyze the dual plasma molecular adsorption system(DPMAS)treatment technology and the laboratory data before and after treatment in patients with liver failure and refractory hyperbilirubinemia,so as to provide a clinical basis for the prediction1andpreventionof common related complicationsM.I ethods A retrospective study was conducted on 161 cases with liver failure and 683cases with refractory hyperbilirubinemia whounderwent DPMAS treatment in our department from October 2022 to July 2024.The general clinical data characteristics,DPMAS treatment status,DPMAS-related complications,and changes in important laboratory indicators before and after the initial DPMAS treatment in both patient groups were analyzed.Results Among the 229 enrolled cases,82.53%were male,and the median age was 50 years.The cause of liver failure was hepatitis B virus infection in 84.47%,while hepatitis B accounted for only 51.47%in the other group.There were significant differences in platelets,creatinine,coagulation function,and inflammatory factor-related indicators between the two groups at baseline.The total number of DPMAS treatments given was 4471 times.The proportion of albumin used in the initial stage of treatment was significantly higher inpatients with refractory hyperbilirubinemia than that in the liver failure group,while the proportion of plasma used in the liver failure group was significantly higher(P<0.001).The most commonly used anticoagulation regimen was unfractionated heparin.A combined anticoagulation therapy regimen was used in 9.3%of the refractory hyperbilirubinemia group.The internal jugular vein was selected in nearly half of the treated cases.A peripheral vascular access pathway was the treatment option in 31.2%.The proportion of centrifugal separation was significantly higher than that of membrane separation(76.22%vs.23.78%).The incidence rate of DPMAS-related complicationswas 16%.The most common complication was bleeding,including bleeding at the puncture site(accounting for 32%of the total complications)and bleeding at nonpuncture sites(12%),followed by hypotension(22%),allergic reactions(13%)and infections(11%),respectively.The indexes of hemoglobin,platelets,total bilirubin,and C-reactive protein were significantly decreased within 24-48 hours after DPMAS treatment in both groups of patients.The prothrombin time and international normalized ratio were significantly increased in theliver failure group,while fibrinogen was significantly reduced.Conclusion DPMAS clinical application is generally safe in patients with liver disease.The most common complications are bleeding hypotension,allergic reactions,and infections,which need to be paid special attention and timely intervention to ensure the safety profile of treatment.
文摘DPE Distributed Processing Environment分布式处理环境DPG Digital Pair Gain数字线对增益DPMA Data Processing Management Association数据处理管理协会DPNSS Digital Private Network Signaling System数字专网信令系统DPRAM Dynamic Programmable Random
