非生物型人工肝对肝衰竭患者临床效果及预后的影响
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摘要
目的研究非生物型人工肝对肝衰竭患者临床效果及预后的影响。方法肝衰竭患者102例随机分成观察组与对照组,每组51例。观察组进行非生物型人工肝治疗方法,对照组进行常规药物治疗方法。比较2组患者8、12、48周治疗效果。以及凝血功能,肝功能,症状等生化指标情况,以及患者治疗生存情况。结果观察组患者血清ALT,总胆红素TBil,与治疗前均有所下降;凝血功能方法,原活动度PTA均有所上升为6.99%,差异有统计学意义(P<0.05)。持续8周治疗过后,观察组治疗有效率明显高于对照组,差异有统计学意义(P<0.05)。持续12周治疗后,观察组患者生存率明显高于对照组,差异有统计学意义(P<0.05)。持续48周治疗后,观察组患者生存天数平均为(191.8±10.3)d,对照组患者生存天数平均为(159.4±20.1)d,且2组患者1年后总有效生存率,观察组43.14%,是明显高于对照组患者41.18%,2组数据差异明显有统计学意义(P<0.05)。结论对肝衰竭患者通过使用非生物型人工肝临床效果明显,不过生存率未能提高。
Objective To investigate the effects of non-biological artificial liver on the clinical outcome and prognosis of patients with liver failure.Methods A total of 102 patients with liver failure who were admitted and treated in our hospital from January 2015 to December 2015 were randomly divided into observation group(n=51) and control group(n=51). The patients in observation group were treated by non-biological artificial liver, however the patients in control group were treated by conventional drug therapy. The therapeutic effects of two groups were observed and compared at 8 w, 12 w, and 48 w after treatment. Moreover the coagulation function, liver function, symptoms and other biochemical indicators, as well as the patient's survival status were observed and compared between the two groups.Results After treatment the serum levels of ALT and total bilirubin(TBil) in observation group were significantly decreased,as compared with those before treatment. Moreover the coagulation function, the original activity PTA were significantly increased by 6.99%, there were statistically significant differences(P<0.05). After 8-week treatment, the effective rate in observation group was significantly higher than that in control group(53.24% vs 36.53%,P<0.05). After 12-week treatment, the survival rate in observation group was significantly higher than that in control group(51.17% vs 43.14%,P<0.05). After 48-week treatment, the average survival time and the total effective survival rate after one year in observation group were significantly higher than those in control group(191.8±10.3 vs 159.4±20.1, 43.14% vs 41.18%,P<0.05).Conclusion The clinical effects of non-biological artificial liver in treatment of liver failure are quite significant, but the survival rate of patients can not be improved.
Objective To investigate the effects of non-biological artificial liver on the clinical outcome and prognosis of patients with liver failure.Methods A total of 102 patients with liver failure who were admitted and treated in our hospital from January 2015 to December 2015 were randomly divided into observation group(n=51) and control group(n=51). The patients in observation group were treated by non-biological artificial liver, however the patients in control group were treated by conventional drug therapy. The therapeutic effects of two groups were observed and compared at 8 w, 12 w, and 48 w after treatment. Moreover the coagulation function, liver function, symptoms and other biochemical indicators, as well as the patient's survival status were observed and compared between the two groups.Results After treatment the serum levels of ALT and total bilirubin(TBil) in observation group were significantly decreased,as compared with those before treatment. Moreover the coagulation function, the original activity PTA were significantly increased by 6.99%, there were statistically significant differences(P<0.05). After 8-week treatment, the effective rate in observation group was significantly higher than that in control group(53.24% vs 36.53%,P<0.05). After 12-week treatment, the survival rate in observation group was significantly higher than that in control group(51.17% vs 43.14%,P<0.05). After 48-week treatment, the average survival time and the total effective survival rate after one year in observation group were significantly higher than those in control group(191.8±10.3 vs 159.4±20.1, 43.14% vs 41.18%,P<0.05).Conclusion The clinical effects of non-biological artificial liver in treatment of liver failure are quite significant, but the survival rate of patients can not be improved.
引文
1 彭明琦,郭岚峰.对危重患儿行非生物型人工肝治疗时的预见性护理.江苏医药,2015,41:239-240.
2 葛许华,喻文亮,陈俊,等.非生物型人工肝支持系统在儿童急性肝衰竭中的应用.中华急诊医学杂志,2013,22:1374-1378.
3 汪亚玲,王丽萍,李晖,等.非生物型人工肝与中药结肠透析优化治疗肝衰竭的临床研究.昆明医科大学学报,2015,36:94-99.
4 贺娜,赵龙斌,郑洋洋,等.序贯应用非生物型人工肝治疗妊娠期急性脂肪肝效果及其安全性的回顾研究.中华肝脏病杂志,2015,23:775-777.
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6 李茂琴,李家琼,史载祥,等.不同组合非生物型人工肝治疗非病毒性急性肝功能衰竭患者的临床研究.中华急诊医学杂志,2014,23:213-215.
7 王泽文,王英杰,罗宾伟,等.非生物型人工肝对肝衰竭患者内毒素及细胞因子的清除作用.第三军医大学学报,2013,25:487-488.
8 杨文龙,孙水林,周锡进,等.终末期肝病模型评分与Child-Turcotte-Pugh分级对非生物型人工肝治疗乙型肝炎相关性肝衰竭患者预测价值的研究.中华危重症医学杂志(电子版),2016,9:20-27.
9 宋立文,李谦,刘欢,等.终末期肝病评分模型在评价慢性肝衰竭人工肝治疗效果中的应用.天津医药,2014,423:466-469.
10 陆长春,蔺咏梅,韩洁,等.人工肝治疗重型肝炎肝衰竭对近期预后的影响.陕西医学杂志,2014,143:318-319.
11 周健,叶俊茂,王雪丽,等.三种评价指标在肝衰竭患者人工肝治疗短期预后中的作用.中华危重症医学杂志(电子版),2011,4:13-18.
12 万小婷.护理干预改善人工肝治疗慢性肝衰竭的效果分析.中国伤残医学,2014,6:242-243.
13 徐玉琴,石文明,李金顺,等.代血浆加白蛋白置换液部分代替血浆进行人工肝治疗肝衰竭的临床效果观察.中国急救医学,2013,33:829-831.
2 葛许华,喻文亮,陈俊,等.非生物型人工肝支持系统在儿童急性肝衰竭中的应用.中华急诊医学杂志,2013,22:1374-1378.
3 汪亚玲,王丽萍,李晖,等.非生物型人工肝与中药结肠透析优化治疗肝衰竭的临床研究.昆明医科大学学报,2015,36:94-99.
4 贺娜,赵龙斌,郑洋洋,等.序贯应用非生物型人工肝治疗妊娠期急性脂肪肝效果及其安全性的回顾研究.中华肝脏病杂志,2015,23:775-777.
5 李小强,陈运超,徐明,等.非生物型人工肝在急性重度中毒性肝病中的临床应用.中国血液净化,2010,9:441-443.
6 李茂琴,李家琼,史载祥,等.不同组合非生物型人工肝治疗非病毒性急性肝功能衰竭患者的临床研究.中华急诊医学杂志,2014,23:213-215.
7 王泽文,王英杰,罗宾伟,等.非生物型人工肝对肝衰竭患者内毒素及细胞因子的清除作用.第三军医大学学报,2013,25:487-488.
8 杨文龙,孙水林,周锡进,等.终末期肝病模型评分与Child-Turcotte-Pugh分级对非生物型人工肝治疗乙型肝炎相关性肝衰竭患者预测价值的研究.中华危重症医学杂志(电子版),2016,9:20-27.
9 宋立文,李谦,刘欢,等.终末期肝病评分模型在评价慢性肝衰竭人工肝治疗效果中的应用.天津医药,2014,423:466-469.
10 陆长春,蔺咏梅,韩洁,等.人工肝治疗重型肝炎肝衰竭对近期预后的影响.陕西医学杂志,2014,143:318-319.
11 周健,叶俊茂,王雪丽,等.三种评价指标在肝衰竭患者人工肝治疗短期预后中的作用.中华危重症医学杂志(电子版),2011,4:13-18.
12 万小婷.护理干预改善人工肝治疗慢性肝衰竭的效果分析.中国伤残医学,2014,6:242-243.
13 徐玉琴,石文明,李金顺,等.代血浆加白蛋白置换液部分代替血浆进行人工肝治疗肝衰竭的临床效果观察.中国急救医学,2013,33:829-831.