人工肝血浆置换术在药物性肝功能衰竭患者中的应用

目的 探讨药物性肝功能衰竭患者行人工肝血浆置换术治疗后的临床效果,并观察相关并发症的护理防治措施.方法 采用回顾性的研究方法,收集2012年7月至2015年7月在本院感染内科住院的100例药物性肝功能衰竭患者的临床资料,所有患者在给予常规方法治疗的基础上(如降酶、退黄、护肝等),进一步给予人工肝血浆置换术治疗.观察患者治疗前、治疗后的凝血功能、肝功能相关指标的动态改变及自觉症状(如纳差、恶心、腹痛等)的改变状况,并进一步归纳患者行人工肝血浆置换术后相关的并发症,探讨并发症出现的因素和相关护理防治方法.结果 大部分患者行人工肝血浆置换术治疗后,纳差、恶心、腹痛等不适症状明显减轻,生命体征较之前明显改善;人工肝治疗后患者的血清丙氨酸氨基转移酶、总胆红素明显降低,与治疗前比较,差异有统计学意义(P<0.05);治疗后,患者的血清白蛋白、凝血功能明显增高,与治疗前比较,差异有统计学意义(P<0.05);治疗后,相关并发症的出现率分别是:对血浆过敏11例(11%)、血压降低5例(5%)、插管处出血2例(2%).结论 药物性肝功能衰竭患者采用人工肝血浆置换术治疗,能显著改善患者的肝功能,大大提高了药物性肝功能衰竭患者的救治成功率,值得临床推广应用.

Nursing on drug-induced hepatic failure patients after artificial liver plasma exchange

Objective To observe the clinical effect of drug-induced hepatic failure patients after artificial liver plasma exchange and observe the nursing control measures of relevant complications.Methods Retrospective research method was used.In addition,the clinical basic information of 100 drug-induced hepatic failure patients hospitalized in the internal infection medicine of this hospital from July 2012 to July 2015 was collected.On the basis of giving conventional treatment to 100 patients (such as lowering transaminase,removing jaundice and hepatic protection,etc),artificial liver plasma exchange treatment was given.The coagulation functions before and after treatment,the dynamic change of the correlated indices of liver function and subjective symptoms (such as poor appetite,nausea and stomachache,etc) of patients were observed.In addition,the relevant complications were further concluded after artificial liver plasma exchange was conducted.In addition,the factors of complications and relevant nursing control method were discussed.Results After artificial liver plasma exchange treatment was conducted, poor appetite,nausea,stomachache and other discomforts of most patients were significantly relieved.The vital signs were significantly improved compared with before.The serum alanine aminotransferase and total bilirubin were significantly reduced after artificial liver treatment for the patients.Compared with the condition before treatment,the difference had statistical significance(P<0.05).The albumin and coagulation function of patients were significantly improved after treatment.Compared with the condition before treatment,the difference had statistical significance(P<0.05).The occurrence rates of relevant complications after treatment were below: allergic to plasma (11 cases, the percentage was 11%), blood pressure reduced (5 cases,the percentage was 5%) and bleeding in intubation (2 cases,the percentage was 11%).Conclusions Artificial liver plasma exchange treatment can significantly improve the liver functions of drug-induced hepatic failure patients,by which the treatment success rate of drug-induced hepatic failure patients can be greatly promoted,which is worth having clinical popularization and application.