人工肝支持系统对药物性肝病的临床疗效及安全性分析

目的分析人工肝支持系统(artificial liver support system,ALSS)对药物性肝病的临床治疗疗效及安全性。方法选取解放军第二○二医院2011年3月-2013年3月收治的86例药物性肝病患者,按照随机数字表进行分组,观察组及对照组各43例,均接受常规内科综合治疗,观察组在此基础上接受ALSS治疗,对比两组患者治疗前后血清生化指标变化,并分析其并发症情况。结果治疗后两组患者ALT、AST、TBA、TBIL均显著降低,其PTA显著上升,观察组改变程度较对照组更为显著(P0.05);观察组痊愈率39.5%,存活率44.2%,死亡患者平均存活天数(29.7±7.1)d,均显著高于对照组的16.3%、25.6%及(15.2±3.9)d(P0.05);观察组43例患者出现72例次并发症,包括9例次(12.5%)血浆反应,21例次(29.2%)呃逆,30例次(41.7%)手足口唇麻木,3例次(4.2%)中空纤维管破裂,5例次(6.9%)血压下降,4例次(5.6%)留置管感染。结论 ALSS能够有效改善药物性肝病患者的症状,提高其治愈率及生存率,并能够有效延长患者生存时间,其并发症处于可控范围内,治疗的安全性也可得到保障,值得推广应用。

Clinical curative effect and safety of artificial liver support system in treatment of drug-induced liver disease

Objective To analyze the clinical curative effect and safety of the artificial liver support system （ALSS） in treatment of drug-induced liver disease.Methods Eighty-six cases of drug-induced liver disease patients in the 202th Hospital of PLA from Mar.2011 to Mar.2013 were divided into two groups according to random number table,the observation group and control group with 43 cases in each group,all patients were treated by the conventional therapy in department of internal medicine,at the same time,the observation group were treated by ALSS,serum biochemical indexes change before and after treatment were compared between two groups,and complications were analyzed.Results After the treatment,ALT,AST,TBA,TBIL were significantly decreased in two groups,the PTA was increased significantly,compared with the control group,the observation group changed more significantly （P ＜ 0.05） ; in observation group,the cure rate was 39.5％,the survival rate was 44.2％,mortality in patients with mean survival time was （29.7±7.1） d,significantly higher than those in the control group 16.3％,25.6％ and （15.2 ± 3.9） d,P ＜ 0.05] ; 43 patients in observation group occurred in 72 cases times of complications,including 9 cases times （12.5％）plasma reaction,21 cases times （29.2％） hiccup,30 cases times （41.7％） foot numbness of lips,3 cases times （4.2％）hollow fiber tube rupture,5 cases times （6.9％） decreased blood pressure,4 cases times （5.6％） catheter infection.Conclusion ALSS can effectively improve the symptoms of patients with drug-induced liver disease,high cure rate and survival rate,and can effectively prolong the survival time of patients,the complications in the controllable range,the safety of the treatment can be guaranteed,therefore,ALSS widely suggest to treat the drug induced liver disease,in order to obtain better prognosis.