血浆透析滤过在重型肝炎血液净化中的应用
摘要
目的探讨血浆透析滤过(PDF)模式在重型肝炎患者治疗中的有效性及安全性。方法分析59例重型肝炎患者经PDF模式治疗前后的肝功能、凝血功能、电解质等血清生化指标变化,进行统计学分析,并对所有患者出院12、24、48周后进行随访,记录患者生存情况。结果通过PDF模式治疗后,重型肝炎患者总胆红素、白蛋白、丙氨酸氨基转移酶、天门冬氨酸氨基转移酶等指标均有所下降(P <0. 001),球蛋白明显升高(P <0. 05);凝血酶原活动度显著升高,凝血酶原时间显著缩短(P <0. 001);血Na~+有所上升(P <0. 001),血K~+稍有下降(P> 0. 05)。出院后12、24、48周重型肝炎患者总体生存率分别为71. 2%(随访52例,存活37例)、66. 7%(随访45例,存活30例)以及46. 4%(随访28例,存活13例)。结论人工肝PDF模式在重型肝炎患者的综合治疗中是一种安全有效的支持治疗手段,适用于临床应用推广。
引文
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[2]王成成,黄芬.肝衰竭研究进展[J].临床内科杂志,2014,31(1):66-67.
[3]Isoniemi H,Koivusalo AM,Repo H,et al.The effect of albumin dialysis on cytokine levels in acute liver failure and need for liver transplantation[J].Transplant Proc,2005,37(2):1088-1090.
[4]陈煜,段钟平.人工肝支持系统在重症肝炎和肝衰竭治疗中的应用[J].临床内科杂志,2008,25(5):299-301.
[5]Stadlbauer V,Davies NA,Sen S,et al.Artificial liver support systems in the management of complications of cirrhosis[J].Semin Liver Dis,2008,28(1):96-109.
[6]Catalina-Rodriguez MV,Banares-Canizares R.Artificial liver support systems:update on albumin dialysis(MARS)[J].Gastroenterol Hepatol,2005,28(8):453-460.
[7]Ting PP,Demetriou AA.Clinical experience with artificial liver support systems[J].Can J Gastroenterol,2000,14 Suppl D:79D-84D.
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[10]中华医学会感染病学分会肝衰竭与人工肝学组,中华医学会肝病学分会重型肝病与人工肝学组.肝衰竭诊治指南(2012年版)[J].实用肝脏病杂志,2013,16(3):210-216.
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[12]Komura T,Taniguchi T,Sakai Y,et al.Efficacy of continuous plasma diafiltration therapy in critical patients with acute liver failure[J].J Gastroenterol Hepatol,2014,29(4):782-786.
[13]中华医学会感染病学分会肝衰竭与人工肝学组.非生物型人工肝治疗肝衰竭指南(2016年版)[J].中华临床感染病杂志,2016,9(2):97-103.