CAJ | 학술논문

目的：观察白蛋白透析联合血浆灌流治疗肝衰竭的安全性及疗效。方法在2010年1月至2012年4月期间，采用白蛋白透析联合血浆灌流治疗肝衰竭患者17例，每次治疗前后检测血常规、生化全套、血凝常规，并观察临床表现及生命体征。治疗前后均数比较采用配对t检验。结果治疗前后患者血红蛋白、血小板、纤维蛋白原等安全性指标均无显著变化（P均＞0．05）。治疗后患者临床症状均有不同程度的改善，乏力、纳差减轻，腹胀有所缓解，精神好转。单次治疗胆红素（t＝12．74，P＜0．01）、肌酐（t＝4．74，P＜0．01）及血氨（t＝7．22，P＜0．01）水平显著下降。肝性脑病好转率71％，肝肾综合征好转率60％，出院时临床总有效率64．7％。结论白蛋白透析联合血浆灌流治疗肝衰竭是一种安全有效的方法，尤其适用于合并肝性脑病、肝肾综合征的肝衰竭患者。
목적：관찰백단백투석연합혈장관류치료간쇠갈적안전성급료효。방법재2010년1월지2012년4월기간，채용백단백투석연합혈장관류치료간쇠갈환자17례，매차치료전후검측혈상규、생화전투、혈응상규，병관찰림상표현급생명체정。치료전후균수비교채용배대t검험。결과치료전후환자혈홍단백、혈소판、섬유단백원등안전성지표균무현저변화（P균＞0．05）。치료후환자림상증상균유불동정도적개선，핍력、납차감경，복창유소완해，정신호전。단차치료담홍소（t＝12．74，P＜0．01）、기항（t＝4．74，P＜0．01）급혈안（t＝7．22，P＜0．01）수평현저하강。간성뇌병호전솔71％，간신종합정호전솔60％，출원시림상총유효솔64．7％。결론백단백투석연합혈장관류치료간쇠갈시일충안전유효적방법，우기괄용우합병간성뇌병、간신종합정적간쇠갈환자。
Objective To evaluate the safety and clinical effect of albumin dialysis combined with plasma perfusion in the treatment of liver failure.Methods Seventeen patients with liver failure were treated with albumin dialysis combined with plasma perfusion from January 2010 to April 2012.The treatment outcomes were evaluated based on the changes in routine blood results,biochemical indices,and blood coagu-lation indices,as well as clinical manifestations and vital signs.Comparison of means before and after treatment was made by paired t-test. Results The patients showed no significant changes in levels of hemoglobin,platelet,and fibrinogen after treatment (P>0.05 for all). After treatment,all patients showed variable improvements in clinical symptoms including weakness,poor appetite,abdominal distension, and low spirit.The patients had significantly decreased levels of total bilirubin (t=12.74,P<0.01 ),creatinine (t=4.74,P<0.01 ), and blood ammonia (t=7.22,P<0.01)after single treatment.Of the patients with hepatic encephalopathy,71%showed improvements, and 60% of patients with hepatorenal syndrome showed improvements.Among all patients,64.7% were cured or showed improvements when discharged.Conclusion Albumin dialysis combined with plasma perfusion is safe and effective in the treatment of liver failure,espe-cially for patients with hepatic encephalopathy and hepatorenal syndrome.