透析与人工器官
透析與人工器官
투석여인공기관
CHINESE JOURNAL OF DIALYSIS AND ARTIFICIAL ORGANS
2014年
3期
1-5
,共5页
重型肝炎%连续白蛋白净化系统(CAPS)%血浆置换(PE)%配对血浆滤过吸附(CPFA)
重型肝炎%連續白蛋白淨化繫統(CAPS)%血漿置換(PE)%配對血漿濾過吸附(CPFA)
중형간염%련속백단백정화계통(CAPS)%혈장치환(PE)%배대혈장려과흡부(CPFA)
severe hepatitis%continuous albumin purification system (CAPS)%plasma exchange (PE)%coupled plasma filtration adsorption(CPFA)
目的：观察两种新型血液净化方法连续白蛋白净化系统联合血浆置换，或配对血浆滤过吸附联合血浆置换治疗中、晚期重型肝炎患者的临床效果。方法选择44例2004年1月至2006年2月住院的重型肝炎患者，将其随机分为3组：PE+CAPS组13例、PE+CPFA组15例和对照组16例。观察各组患者治疗前后肝功能、肾功能、凝血功能指标、血氨、电解质、血气分析及血常规，并进行对比分析。结果 PE+CAPS与PE+CPFA治疗后肝功能较对照组明显改善，且凝血功能较治疗前明显改善。PE+CAPS组治疗后肾功能明显好转，TBIL下降幅度为42.00%；PE+CPFA组治疗后TBIL下降幅度为35.53%。PE+CAPS组总存活率为61.5%，PE+CPFA组总存活率为53.3%，对照组总存活率为25.0%。结论由于中、晚期重型肝炎肝脏坏死面积较大，建议尽早进行PE联合CPFA或CAPS治疗，合并肝肾综合征或肝性脑病者首选CAPS治疗。
目的：觀察兩種新型血液淨化方法連續白蛋白淨化繫統聯閤血漿置換，或配對血漿濾過吸附聯閤血漿置換治療中、晚期重型肝炎患者的臨床效果。方法選擇44例2004年1月至2006年2月住院的重型肝炎患者，將其隨機分為3組：PE+CAPS組13例、PE+CPFA組15例和對照組16例。觀察各組患者治療前後肝功能、腎功能、凝血功能指標、血氨、電解質、血氣分析及血常規，併進行對比分析。結果 PE+CAPS與PE+CPFA治療後肝功能較對照組明顯改善，且凝血功能較治療前明顯改善。PE+CAPS組治療後腎功能明顯好轉，TBIL下降幅度為42.00%；PE+CPFA組治療後TBIL下降幅度為35.53%。PE+CAPS組總存活率為61.5%，PE+CPFA組總存活率為53.3%，對照組總存活率為25.0%。結論由于中、晚期重型肝炎肝髒壞死麵積較大，建議儘早進行PE聯閤CPFA或CAPS治療，閤併肝腎綜閤徵或肝性腦病者首選CAPS治療。
목적：관찰량충신형혈액정화방법련속백단백정화계통연합혈장치환，혹배대혈장려과흡부연합혈장치환치료중、만기중형간염환자적림상효과。방법선택44례2004년1월지2006년2월주원적중형간염환자，장기수궤분위3조：PE+CAPS조13례、PE+CPFA조15례화대조조16례。관찰각조환자치료전후간공능、신공능、응혈공능지표、혈안、전해질、혈기분석급혈상규，병진행대비분석。결과 PE+CAPS여PE+CPFA치료후간공능교대조조명현개선，차응혈공능교치료전명현개선。PE+CAPS조치료후신공능명현호전，TBIL하강폭도위42.00%；PE+CPFA조치료후TBIL하강폭도위35.53%。PE+CAPS조총존활솔위61.5%，PE+CPFA조총존활솔위53.3%，대조조총존활솔위25.0%。결론유우중、만기중형간염간장배사면적교대，건의진조진행PE연합CPFA혹CAPS치료，합병간신종합정혹간성뇌병자수선CAPS치료。
Objective To observe the clinical results in patients with middle and advanced stages of severe hepatitis by two new methods of blood purification, continuous albumin purification system combined with plasma ex-change, or coupled plasma filtration adsorption combined with plasma exchange. Methods Choose 44 patients with severe hepatitis hospitalized from January 2004 to February 2006, and divide into three groups, 13 patients in PE+CAPS group, 15 patients in PE+CPFA group and 16 patients in control group. Observe liver function, kidney func-tion, coagulation parameters, ammonia, electrolytes, blood gas analysis and blood of patients in each group before and after treatment, and make comparative analysis. Results In PE+CAPS and PE+CPFA group liver function was im-proved significantly after treatment, and coagulation function was improved significantly compared with that before the treatment. In PE+CAPS group renal function improved significantly after treatment, TBIL decreased 42.00%; In PE+CPFA group TBIL decreased 35.53%after treatment. Overall survival rate was 61.5%in PE+CAPS group, overall survival rate was 53.3%in PE+CPFA group,and overall survival rate was 25.0%in control group. Conclusion Due to the larger liver necrosis area in patients with middle and advanced stages of severe hepatitis, it is suggested that PE combined with CPFA or CAPS treatment as soon as possible, and hepatorenal syndrome and hepatic encephalopathy preferred CAPS treatment.
