人工肝血浆置换术治疗肝衰竭病人的临床疗效及预后分析

曹蕴; 徐葵花; 赵守松

doi:10.13898/j.cnki.issn.1000-2200.2018.12.008

人工肝血浆置换术治疗肝衰竭病人的临床疗效及预后分析

蚌埠医学院第一附属医院感染科, 安徽蚌埠 233004

作者简介: 曹蕴(1979-),女,主治医师.

中图分类号: R575.3

The clinical efficacy and prognosis analysis of the artificial liver plasma replacement in the treatment of liver failure

Department of Infectious Disease, The First Affiliated Hospital of Bengbu Medical College, Bengbu Anhui 233004, China
CLC number: R575.3

摘要: 目的：探讨人工肝血浆置换治疗40例肝衰竭病人的临床疗效，评估采用终末期肝脏模型（MELD）评分对肝衰竭的预后判断的价值。方法：回顾性分析40例应用人工肝血浆置换术治疗的肝衰竭病人的临床资料，判断其临床疗效。并对40例肝衰竭病人进行MELD评分分组，观察其临床结局。结果：血浆置换术治疗前后，病人的主要实验室指标丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、总胆红素、肌酐、凝血酶原时间、国际标准化比值较治疗前明显下降（P<0.05~P<0.01），胆碱酯酶、白蛋白、凝血酶原活动度较治疗前明显提高（P<0.01）。40例肝衰竭病人行血浆置换术治疗共140例次，其中4例次出现不良反应，总发生率2.8%。其中30例病人有效，10例病人无效，总有效率为75%。MELD评分高者，人工肝治疗的无效率会较高，但无效率差异无统计学意义（P>0.05）。结论：对于肝衰竭病人，使用血浆置换进行治疗临床效果好、不良反应少。MELD评分用于判断肝衰竭病人预后的效果仍需进一步研究。
- 肝功能衰竭 /
- 血浆置换 /
- 终末期肝病模型评分
Abstract: Objective:To investigate the clinical effects of artificial liver plasma replacement in the treatment of liver failure in 40 patients,and evaluate the value of model for end-stage liver disease(MELD) score in predicting the prognosis of liver failure.Methods:The clinical data of 40 liver failure patients treated with artificial liver plasma replacement were retrospectively analyzed.The clinical effects and MELD scores of the patients were evaluated,and the clinical outcome of the patients was observed.Results:After the plasma replacement,the levels of ALT,AST,TBIL,Cr,PT and INR significantly decreased(P<0.05 to P<0.01),and the levels of CHE,ALB and PTA significantly increased compared with before treatment(P<0.01).The patients were treated with artificial liver plasma replacement for 140 times,the adverse reactions occurred in 4 times,and the incidence rate of which was 2.8%.Thirty cases were effective,10 cases were invalid,and the effective rate of which was 75%.The invalid rate of artificial liver treatment in three groups with high MELD scores was higher,and the difference of invalid rate was not statistically significant(P>0.05).Conclusions:The plasma replacement has good clinical effects and few adverse reactions.MELD sore as a predicting prognosis indictor of plasma replacement treating liver failure needs further research.
- liver failure /
- plasma replacement /
- model for end stage liver disease score

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人工肝血浆置换术治疗肝衰竭病人的临床疗效及预后分析

作者简介: 曹蕴(1979-),女,主治医师.

The clinical efficacy and prognosis analysis of the artificial liver plasma replacement in the treatment of liver failure

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人工肝血浆置换术治疗肝衰竭病人的临床疗效及预后分析

作者简介: 曹蕴(1979-),女,主治医师.

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The clinical efficacy and prognosis analysis of the artificial liver plasma replacement in the treatment of liver failure

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人工肝血浆置换术治疗肝衰竭病人的临床疗效及预后分析

作者简介: 曹蕴(1979-),女,主治医师.

The clinical efficacy and prognosis analysis of the artificial liver plasma replacement in the treatment of liver failure

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人工肝血浆置换术治疗肝衰竭病人的临床疗效及预后分析

作者简介: 曹蕴(1979-),女,主治医师.

English Abstract

The clinical efficacy and prognosis analysis of the artificial liver plasma replacement in the treatment of liver failure

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目录