中间型和混合型人工肝对肝衰竭支持效果对比研究

目的比较中间型(血浆置换)和混合型(血浆置换 血液灌流吸附)人工肝支持方法对肝衰竭患者肝功能的支持效果及安全性.方法51例重型肝炎肝衰竭患者分别进行血浆置换(17例)和血浆置换 血液灌流吸附(34例)治疗,观察治疗前后患者临床症状变化,比较治疗前后肝肾功能、血常规、PT变化.结果血浆置换和血浆置换 血液灌流吸附治疗后,患者的临床症状均有不同程度改善.两种方法治疗后转氨酶、总胆红素、直接胆红素、凝血酶原时间、总蛋白下降、凝血酶原活动度升高均有显著性差异(P＜0.05或P＜0.01),但两种治疗方法间比较各项指标变化程度均无显著性差异.两种方法治疗的不良反应均较轻.结论中间型、混合型人工肝对重型肝炎肝衰竭患者的肝功能均有肯定的支持效果.

Comparitive study of middle and mixed artificial livers in treatment of hepatic failure

Objective: Non-bioartificial liver was applied to clinic, but the reported efficacy was different. The aim of this article is to compare the efficacy and safety of middle (plasma exchange) and mixed (plasma exchange plus hemoperfusion absorption) in treatment of hepatic failure.Methods:Fifty-one patients with hepatic failure were treated with plasma exchange therapy (17 cases) and plasma exchange plus hemoperfusion adsorption therapy (34 cases). The data before and after treatment of liver function, renal function, blood routine test, prothrombin time (PT), prothrombin activity (PTa) were analyzed.Results:Clinical symptoms of patients were ameliorated after treatment. The levels of aminotransferase, total bilirubin, direct bilirubin, PT, the level of total serum proteins decreased significantly and PTa increased significantly after two therapies ( P <0.05 or P <0.01). There was no significant difference of descent or rising level between two groups ( P >0.1 or P >0.25).The side effects were poor and limited in all patients.Conclusion:Two therapies were effective in the treatment of hepatic failure.