非生物型人工肝治疗儿童急性肝衰竭的疗效分析

目的:探讨非生物型人工肝治疗儿童急性肝衰竭(acute liver failure,ALF)的疗效。方法:回顾分析2008年8月—2013年7月复旦大学附属儿科医院收治的47例儿童ALF患者的临床资料,其中17例患者采用常规内科综合治疗(对照组),30例患者在常规内科综合治疗基础上采用非生物型人工肝治疗(研究组),分析ALF患儿的年龄分布特征及病因情况,比较研究组患儿治疗前后主要生化指标、凝血功能指标的变化以及2组患儿病死率。结果:47例ALF患儿中≤1岁患儿23例、1~3岁10例、≥3岁14例;34.0%患儿病因不明。与治疗前比较,研究组患儿治疗后血清总胆红素(total bilirubin,TBIL)、丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)均降低(P0.05),国际化标准比值(international normalized ratio,INR)、凝血酶原活度(prothrombin time activity,PTA)、白蛋白(albumin,ALB)均升高(P0.05)。研究组病死率低于对照组,但差异无统计学意义。结论:非生物型人工肝治疗儿童ALF是有效的,可改善患儿的生化指标、凝血功能及预后。

Efficacy of Non-Bioartificial Liver in the Treatment of Children with Acute Liver Failure

Objective：To investigate the clinical effectiveness of non-bioartificial liver in the treatment of children with acute liver failure（ALF） .Methods ：The clinical datum of 47 children with ALF from Aug 2008 to Jul 2013 treated in Children＇s Hos-pital ,Fudan University were retrospectively analyzed .Among them ,17 children were treated with only conventional compre-hensive medical treatment （control group） ,and the other 30 children were treated with non-bioartificial liver in addition to con-ventional comprehensive medical treatment （study group） .The distributing characteristics of age and etiological factors were analyzed .The main biochemical parameters and coagulation function parameters before and after treatment were compared in the study group and mortality rate was compared between the two groups .Results：In 47 children with ALF ,the cases ≤1 year old ,1-3 years old and ≥3 years old were 23 ,10 and 14 ,respectively .The percentage of unknown reasons in children with ALF was 34 .0% .Compared with before treatment ,serum total bilirubin（TBIL） ,alanine aminotransferase（ALT） and aspartate ami-notransferase（AST） decreased after treatment in the study group （P〈0 .05） ,and international normalized ratio （INR） ,pro-thrombin time activity（PTA） ,and albumin（ALB） significantly increased（P〈0 .05） .The mortality rate in the study group was lower than that in the control group ,but the difference was not statistically significant .Conclusions ：Non-bioartificial liver is effective for the treatment of children with ALF ,and can improve biochemical parameters ,coagulation function and prognosis .