MARS治疗6例肝功能衰竭体会

目的本研究探讨分子吸附再循环系统（MARS）在6例急性肝衰竭和慢性基础上急性加重患者中应用的效果。方法6例患者包括毒蘑菇中毒、肝癌、败血症休克、慢性肝衰竭急性加重等，其肝功能均严重受损，检测指标包括血氨、血总胆红素、直接胆红素、血尿素氮、血肌酐、肝性脑病级别等。结果经单次MARS治疗后血氨均有所下降，血总胆红素下降17．6％～40．0％，血肌酐及尿素氮均有不同程度下降。结论MARS是一种有效的人工肝支持系统，血胆红素越高其清除效果越明显，但对肝癌的效果差，治疗败血症休克需联合其他血液透析方式。

Molecular adsorbent recirculating system(MAPS) treating liver failure: 6 cases reports

Objective To report the application of MARS in 6 patients with acute liver failure and acute-onchronie liver failure. Methods Six patients with severely impaired liver function including one with poisonous mushroom, one with liver cancer, two with sepsis, two with acute-on-chronic liver failure were treated with MARS. Clinical data included arterial ammonia levels, serum total bilirubin and direct bilirubin levels, BUN, serum ereatinine（Scr） and hepatic encephalopathy grade were collected. Results After MARS, the levels of ammonia, BUN and Scr decreased, the levels of serum total bilirubin decreased with 17.6% - 40.0%. Conclusion MARS is an effective artificial extracorporeal liver support system, which probably is more effective in patients with higher bilirubin level. MARS can not improve the prognosis of patients with hepatic carcinoma, and combination of MARS and other methods is needed to treat sepsis patients.