人工肝脏支持系统对妊娠并发重症肝炎的临床疗效分析

目的探讨人工肝脏支持系统(artificial liver support system,ALSS)对妊娠并发重症肝炎的临床疗效。方法选取成都市公共卫生临床医疗中心2008年5月-2010年3月收治的176例妊娠并发重症肝炎患者,随机分为观察组88例,接受ALSS治疗,对照组88例,接受常规内科治疗,对比两组患者治疗前后肝功能指标及内毒素变化,并对其并发症情况进行分析。结果观察组有效80例(90.9%),对照组有效47例(53.4%),观察组治疗效果明显优于对照组(P0.05);两组患者治疗后TB、ALT、AST、TBA及ENDOT均显著下降,且观察组下降程度较对照组更为明显(P0.05);观察组发生并发症的患者33例(37.5%),对照组27例(30.7%),两组并发症发生率差异无统计学意义(P0.05),观察组病死2例(2.3%),对照组病死6例(6.8%),观察组病死率明显低于对照组(P0.05)。结论人工肝脏支持系统可有效改善妊娠并发重症肝炎患者的临床症状,代偿肝脏功能,从而使体内毒性物质得到有效清除,降低肝功能衰竭的进展率,临床疗效十分显著,且该疗法安全性高,患者恢复快,适合临床广泛推广。

The clinical efficacy of artificial liver support system for pregnancy complicated with severe hepatitis

Objective To investigate the clinical efficacy of artificial liver support system for pregnancy complicated with severe hepatitis.Methods One hundred and seventy-six cases of pregnancies complicated with severe hepatitis patients in Public Health Clinical Medical Center in Chengdu from May.2008 to Mar.2010 were divided into two groups,according to the random number table under their informed consent,the observation group （88 cases） received ALSS treatment and the control group （88 cases） received conventional medical treatment.The liver function before and after endotoxin were compared between two groups,and the complications were analyzed.Results Eighty cases （90.9％） in the observation group were effective and 47 cases （53.4％） in the control group were effective.The clinical efficacy in the observation group was better than that in the control group.After treatment,TB,ALT,AST,TBA and ENDOT were significantly decreased in both groups,and the decrease in the extent of the observation group was significantly more than that in the control group （P ＜ 0.05）.The observation group had complications in 33 patients （37.5％） while 27 patients in the control group （30.7％）,but there was more statistically significant （P ＞ 0.05）.Two patients （2.3％） died in the observation group and six cases （6.8％） died in the control group,mortality was significantly lower in observation group than that in the control group （P ＜ 0.05）.Conclusion The artificial liver support system can effectively improve pregnancy complicated with clinical symptoms in patients with severe hepatitis,decompensate liver function,so that the body can effectively remove toxic substances,reduce the rate of progression of liver failure,which has very excellent clinical efficacy and safety of the therapy and the patients recover quickly,which is suitable for clinic widely.