人工肝支持系统治疗慢性重型肝炎的临床研究

目的探讨利用普通血液透析机进行人工肝(血浆置换联合血液透析)治疗慢性重型肝炎的临床疗效。方法对68例慢性重型肝炎进行186次人工肝支持治疗,观察治疗前、后临床症状的变化,血生化肝、肾功能指标的变化,预后情况及不良反应。结果全部病例均出现精神状态好转,肝性脑病程度减轻,乏力、腹胀减轻,食欲改善,尿量增加,全身水肿减轻;肝功能指标有明显改善:TBIL、ALT、AST、TBA、BUN、Cr、NH3均明显降低,ALB、PA 均明显提高(P<0.001～<0.05)。早、中期患者存活率明显高于晚期患者,两者比较有显差异(P<0.001)。结论利用普通血液透析机进行人工肝(血浆置换联合血液透析)治疗慢性重型肝炎操作方便,治疗安全、有效;人工肝治疗时应掌握时机,早期治疗。

Clinical study on artificial liver support system in treatment of patients with chronic fulminant viral hepatitis

Objective To clinically evaluate the treatment with artificial liver support system(ALSS)in combination with plasma exchange and hemodialysis in chronic fulminant viral hepatitis using common hemodialysis machine.Methods Sixty-eight cases were treated with 186 times of ALSS,clinical manifestations were recorded and serum biochemical tests were performed before and after treat- ment with ALSS.Results In all cases,clinical symptoms and signs such as spirits,eneephalopathy,appetite and edema were improved significantly.Liver function parameters such as serum alanine transaminase(ALT)level,total bilirubin level(TBIL),aspartate amin- otransferase(AST),total bilirubin acid(TBA),blood urea nitrogen(BUN),creatinine(Cr)and blood ammonia.were markedly im- proved after treatment with ALSS.Serum albumin and prothrombin time activity were greatly improved(All P<0.05).The patients in early and middle stage groups had a better livability than late stage patients(P<0.05).Condusions By using common hemodialysis machine,ALSS treatment for chronic fulminant viral hepatitis can alleviate the organ damage and improve the clinical curative rate. ALSS treatment should be applied in early stage of chronic fulminant viral hepatitis.