混合型人工肝治疗肝衰竭疗效观察

目的　评价混合型人工肝支持方法———血浆置换 +血液灌流吸附治疗肝衰竭的临床疗效、安全性及其对血浆内毒素的清除作用。方法　 3 4例肝衰竭患者进行血浆置换 +血液灌流吸附治疗 ,比较治疗前后肝肾功、血常规、PT、血浆内毒素水平的变化 ,观察治疗后患者临床症状体征情况等变化。结果　血浆置换 +血液灌流吸附治疗后 ,患者的临床症状均有不同程度改善 ,总有效率为 67.6% ,最终存活率仅为 2 9.1%。检测指标中转氨酶、总胆红素、凝血酶原时间、凝血酶原活动度、内毒素水平较治疗前后差异有显著性意义 (P <0 .0 1,P <0 .0 5 ) ,不良反应较轻。结论　混合型人工肝对肝衰竭有肯定的疗效 ,对血浆内毒素有确定的清除作用

Therapeutic efficacy of the mixed artificial liver in the treatment of hepatic failure

Objective To evaluate the clinical effect, safety and removal effect on plasma endotoxin of the mixed artificial liver plasma exchange plus hemoperfusion absorption in the treatment of hepatic failure. Methods A total of 34 patients with hepatic failure were treated with plasma exchange plus hemoperfusion absorption. The results of liver function, renal function, blood routine test, prothrombin time(PT), prothrombin time activity(PTa) and plasma endotoxin level before and after the treatment were analyzed. All the patients were observed closely. Results Symptoms of patients treated with plasma exchange plus hemoperfusion absorption were improved. The total effective rate reached 67.6%, but the survival rate was only 29.1%. Compared with those before the therapy, there was significant difference in aminotransferase, total bilirubin, PT, PTa and plasma endotoxin level after treatment( P < 0.05 or P <0.01). The side effects were very limited. Conclusion Mixed artificial liver is effective in the treatment of hepatic failure and is of removal effect on plasma endotoxin.