华中科技大学学报（医学版）
華中科技大學學報（醫學版）
화중과기대학학보（의학판）
ACTA UNIVERSITATIS MEDICINAE TONGJI
2015年
1期
87-91
,共5页
少量血浆%人工肝支持系统%慢加急性肝衰竭
少量血漿%人工肝支持繫統%慢加急性肝衰竭
소량혈장%인공간지지계통%만가급성간쇠갈
less fresh frozen plasma%artificial liver support system%acute-on-chronic liver failure
目的：观察应用少量血浆进行人工肝治疗慢加急性肝衰竭的疗效。方法回顾性分析45例住院治疗的慢加急性肝衰竭患者，分为观察组（少量血浆PP＋ PE组）、对照组1（PE组）、对照组2（PP＋PE组）（PP为血浆吸附，PE为血浆置换），共接受人工肝治疗62次。结果3组患者治疗后与治疗前比较，临床症状均有所改善。3组间相比较，在降低谷丙转氨酶（ALT）、谷草转氨酶（AST）、直接胆红素（DBil）这3个指标上差异有统计学意义，对于总胆红素（TBil）的改善和降低血氨等方面无明显差异。在其余肝、肾功能各项指标上3组间差异无统计学意义。与对照组1和对照组2相比，观察组在改善凝血功能方面效果较差，差异有统计学意义。结论在目前血浆紧张的情况下，可以应用血浆吸附联合少量新鲜冰冻血浆进行人工肝治疗，能有效降低胆红素，缓解临床症状，减少并发症的发生。
目的：觀察應用少量血漿進行人工肝治療慢加急性肝衰竭的療效。方法迴顧性分析45例住院治療的慢加急性肝衰竭患者，分為觀察組（少量血漿PP＋ PE組）、對照組1（PE組）、對照組2（PP＋PE組）（PP為血漿吸附，PE為血漿置換），共接受人工肝治療62次。結果3組患者治療後與治療前比較，臨床癥狀均有所改善。3組間相比較，在降低穀丙轉氨酶（ALT）、穀草轉氨酶（AST）、直接膽紅素（DBil）這3箇指標上差異有統計學意義，對于總膽紅素（TBil）的改善和降低血氨等方麵無明顯差異。在其餘肝、腎功能各項指標上3組間差異無統計學意義。與對照組1和對照組2相比，觀察組在改善凝血功能方麵效果較差，差異有統計學意義。結論在目前血漿緊張的情況下，可以應用血漿吸附聯閤少量新鮮冰凍血漿進行人工肝治療，能有效降低膽紅素，緩解臨床癥狀，減少併髮癥的髮生。
목적：관찰응용소량혈장진행인공간치료만가급성간쇠갈적료효。방법회고성분석45례주원치료적만가급성간쇠갈환자，분위관찰조（소량혈장PP＋ PE조）、대조조1（PE조）、대조조2（PP＋PE조）（PP위혈장흡부，PE위혈장치환），공접수인공간치료62차。결과3조환자치료후여치료전비교，림상증상균유소개선。3조간상비교，재강저곡병전안매（ALT）、곡초전안매（AST）、직접담홍소（DBil）저3개지표상차이유통계학의의，대우총담홍소（TBil）적개선화강저혈안등방면무명현차이。재기여간、신공능각항지표상3조간차이무통계학의의。여대조조1화대조조2상비，관찰조재개선응혈공능방면효과교차，차이유통계학의의。결론재목전혈장긴장적정황하，가이응용혈장흡부연합소량신선빙동혈장진행인공간치료，능유효강저담홍소，완해림상증상，감소병발증적발생。
Objective To observe the efficacy of extracorporeal liver support by using less fresh frozen plasma in the treat‐ment of acute‐on‐chronic liver failure.Methods A total of 45 patients with acute‐on‐chronic liver failure were divided into ob‐servation group[plasma perfusion(PP) with a small amount of plasma+ plasma exchange(PE)] ,control group 1(PE) ,control group 2(PP+PE)in terms of the amount of plasma used on the day of treatment. All the patients received artificial liver treatnts 62 times totally.Results The clinical symptoms were improved in the three groups after treatments.There were significant differences in the decrease of alanine transaminase (ALT) ,aspartate transaminase(AST) and direct bilirubin(DBil)rather than the decrease of total bilirubin(TBil)and blood ammonia among the groups.No significant difference was noted in the liver and kidney function among the three groups. The improvement of the coagulation function was poor in the observation group when compared with the control group 1 and control group 2 and there were significant differences.Conclusion During the short sup‐ply of the plasma ,plasma perfusion combined with small amount of plasma can be considered to be used in artificial liver treat‐ments ,which can effectively decrease the level of TBil ,relieve symptoms and decrease the occurrence of complications.
