血浆置换治疗急性妊娠脂肪肝3例体会

目的通过在急性妊娠脂肪肝的治疗中应用非生物型人工肝——血浆置换,分析评价人工肝血浆置换治疗在该病中的治疗作用、安全性。方法3例急性妊娠脂肪肝患者,在内科保守治疗的同时应用非生物型人工肝血浆置换,观察病情变化,血浆置换治疗前后患者的肝肾功能、血浆白蛋白、血常规、血液凝固时间的变化,以及血浆置换治疗的时机、副作用等。结果通过内科保守治疗,及时应用非生物型人工肝血浆置换,3例患者的症状、体征明显改善,肝肾功能明显好转,白细胞数明显下降(P<0.05),而PT、APTT、HB、PLt无明显变化(P>0.05)。血浆置换治疗中仅1例次出现皮肤搔痒,1例次出现轻度手足抽搐,无一例因不良反应而中止治疗。结论血浆置换治疗急性妊娠脂肪肝安全有效,并发症少,在病程早期连续应用更能有效地阻止病情进展。

The clinical study of plasma exchange in acute pregnant fatty liver

Objective To study the effect of plasma exhange(PE) on acute fatty liver in pregnant patients. Methods Three pregnant patients with acute fatty liver were treated with PE,their alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBiL),director bilirubin(DBiL),blood urea nitrogen(BUN),reatinine(Cr),total protein(TP),white blood cell(WBC),activated partial thromboplastin time(APTT) and prothromin time(PT) were measured before and after PE. Result The liver function of 3 patients had been recovered completely after treatment with PE. Conclusion The PE treatment for acute fatty liver in pregnant patients is effective and safe.