体外生物人工肝支持系统治疗肝功能衰竭的系统评价

背景：生物人工肝支持系统由生物反应器和细胞材料组成，治疗过程中可部分替代肝脏的主要功能如解毒、合成、分泌和生物转化等功能。目的：回顾和评价体外生物人工肝支持系统近15年来治疗肝功能衰竭的疗效。方法：检索1995至2009年PubMed和Cochrane数据库有关生物人工肝支持系统的临床研究。被纳入的研究类型包括随机对照试验、临床对照试验和病例报告。结果与结论：共纳入31项研究，在生物人工肝支持系统治疗之后，患者生化指标呈现好转趋势，且大部分患者神经系统症状均得到改善，但多数患者生存率未见明显改善。说明尽管生物人工肝支持系统被证明具有一定治疗效果，但今后仍然有许多方面需要改进。

Systematic evaluation of extracorporeal bioartificial liver support system for the treatment of liver failure

BACKGROUND： Bioartificial liver support system is composed of the bioreactors and the cellular materials which could partially replace the major liver functions, including detoxification, synthesis, secretion and biotransformation. OBJECTIVE： To overview and evaluate the current clinical effect of extracorporeal bioartificial liver support system for the treatment of liver failure over the past 15 years. METHODS： Relevant clinical studies from 1995 to 2009 were retrieved from PubMed database and Cochrane Library database. Enrolled studies included randomized controlled trials, controlled clinicatrials and case reports. RESULTS AND CONCLUSIONS： Thirty-one studies were included. There was a trend of falling into the normal ranges with the clinical and biochemical parameters after bioartificial liver support system treatment. The neurological status of most patients was improved or stabilized during bioartificial liver support system treatment as well. No significant effect on survival rate could be seen after bioartificial liver support system treatment. Although, bioartificial liver support system has proved to be a success in some clinical cases, it still needs to be improved greatly in many aspects.