人工肝血浆置换术治疗药物性亚急性肝功能衰竭患者的护理

目的探讨人工肝血浆置换术治疗药物性亚急性肝功能衰竭患者的临床观察与并发症防范护理措施。方法回顾性分析2007年12月至2010年12月温州医学院附属第一医院收治的50例药物性亚急性肝功能衰竭患者的临床资料,所有患者均在护肝、降酶等综合治疗的基础上进行血浆置换治疗。分析治疗前后患者肝功能、凝血功能的变化和临床症状如乏力、食欲缺乏、腹胀等改善情况以及对人工肝治疗中出现的并发症情况,总结并发症的发生原因及预防护理措施。结果人工肝治疗后,多数患者临床症状明显改善,表现为精神好转,乏力、腹胀及消化道症状明显减轻;治疗后血清总胆红素、丙氨酸氨基转移酶明显下降,白蛋白、凝血指标升高。并发症发生率高低依次为血浆过敏反应(6人次)、低血压(2人次)、插管处出血(1人次)。结论人工肝血浆置换术治疗药物性亚急性肝功能衰竭,可以改善患者肝功能,提高早、中期患者救治成功率;提倡尽早予以人工肝治疗。规范、细致的临床护理是提高人工肝血浆置换术治疗药物性亚急性肝功能衰竭成功率的重要保证,正确预防处理并发症是提高治疗安全性的关键。

Nursing of Drug-induced Sub-acute Liver Failure Treated with Artificial Liver Plasma Replacement

Objective To investigate the clinical nursing observation and preventive nursing measures for drug-induced sub-acute liver failure treated with artificial liver plasma replacement.Methods The clinical data of 50 patients with drug-induced sub-acute liver failure from December 2007 to December 2010 were analyzed retrospectively.All the treatments were conducted on the basis of a comprehensieve therapy of protecting liver,reducing enzyme,and dropping jaundice.We respectively investigated and analyzed the liver function,kidney function,serum electrolyte,cruor function,and clinical symptoms,such as weakness,apocleisis,and abdominal distension.We also analyzed the cause for the complications and prevention measures.Results After artificial liver plasma replacement,the clinical symptoms were significantly improved in a majority of patients,in term of improvement in mental status,the symptoms of fatigue,abdominal distension and alimentary tract were relieved;the serum total bilirubin,alanine aminotransferase were obviously decreased,and the serum albumin,cruor function distinctly were elevated.The hospital stays was dramatically shortened.Plasma allergic reaction（n=6）,hypotension（n=2）,and intubation bleeding（n=1） were the most common complications.Conclusion Artificial liver plasma replacement can improve liver function,increase treatment success rate of early and middle stage patients with drug-induced sub-acute liver failure.Standard and careful clinical care is an important guarantee to elevating the success rate of patients with drug-induced sub-acute liver failure,which is a key measure to correctly prevent and process complications.