人工肝联合肝移植治疗慢性肝衰竭的临床体会

目的 总结目前常用人工肝治疗方法:血浆置换(Plasma exchange)、血液灌流(Hemoperfusion)和分子吸附再循环系统(Molecular adsorbent recirculatint system)联合肝移植治疗慢性肝功能衰竭的经验。方法 对7例慢性肝脏功能衰竭患者分别应用上述三种人工肝方法治疗15人次,于治疗前后分别检测肝功能、凝血酶原活动度、血氨等指标,并观察临床症状、体征变化。人工肝支持治疗后接受原位肝移植治疗。结果 人工肝治疗后多数患者的乏力、纳差、腹胀等症状明显缓解,7例均顺利进行原位肝脏移植,其中6例成活。结论 人工肝可明显改善慢性肝功能衰竭患者术前状况,为肝移植赢得时间和创造条件。

A clinical study about hepatic function failure patients treated with nonbiological artificial livers and orthotopic liver transplantation

Objective To summarize the clinical effects, safety and indication of plasina exchange , hemoperfu-sion and molecular adsorbent recycling svstem (MARS) combined with orthotopic liver transplantation for patients with hepatic function failure. Methods 7 patients with severe liver failure were tieated with above hepatic assistant sys-tems. The clinical signs and svmptoms, total serum bilirubin (TBIL), ammonia and prothrombin activity (PTA) were recorded or detected before and after treatment, the successful rate of bridging to orthotopic liver transplantation also was observed. Results Most patients' symptoms such as pruritus, jaundice, hvperbilirubinemia were improved after the artificial liver treatment,and then all padents were bridged to OLT. 6 cases survived successfully.There were no severe complications during artificial h'ver treatment. Condusioo Artificial livers could improve patients' condition and be used as a effective bridge to orthotopic transplantation for hepatic failure.