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 (血浆置换加血液灌流吸附 )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　 1999- 0 1～ 2 0 0 2 - 0 2第三军医大学西南医院住院的 5 1例重型病毒性肝炎肝衰竭患者分别进行血浆置换 (17例 )和血浆置换加血液灌流吸附 (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、凝血酶原时间变化。结果　血浆置换和血浆置换加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、凝血酶原活动度的改善程度均差异有显著性 (P <0 0 5 ) ,但两种治疗方法间比较各项指标变化程度均差异无显著性。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。

Comparison study of middle and mixed artificial liver in treatment of hepatic failure

Objective To compare the efficacy and safety of middle and mixed artificial liver-plasma exchange and plasma exchange plus hemoperfusion adsorption in treatment of hepatic failure.Methods Fifty-one patients with hepatic failure were treated with plasma exchange (17 cases) and plasma exchange plus hemoperfusion adsorption (34 cases).The results of liver function,renal function,blood routine test, prothrombin time (PT),prothrombin time activity (PTa) before and after the treatment were analyzed.Results Symptoms of patients treated with middle and mixed artificial liver were improved.Compared with those before the therapy,there was significant descent in aminotransferase,total bilirubin,direct bilirubin,PT,total serum proteins,and significant rise in PTa in two groups after treatment (P<0.05 or P<0.01).There was no significant difference of descent or rise level between two groups (P>0.1 or P>0.25).The side-effects were very limited in two groups.Conclusion Middle and mixed artificial liver is effective in treatment of hepatic failure.