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目的 比较中间型 (血浆置换 )和混合型 (血浆置换 +血液灌流吸附 )人工肝支持方法对肝衰竭患者肝功能的支持效果及安全性。方法 5 1例重型肝炎肝衰竭患者分别进行血浆置换 (17例 )和血浆置换 +血液灌流吸附 (34例 )治疗 ,观察治疗前后患者临床症状变化 ,比较治疗前后肝肾功能、血常规、PT变化。结果 血浆置换和血浆置换 +血液灌流吸附治疗后 ,患者的临床症状均有不同程度改善。两种方法治疗后转氨酶、总胆红素、直接胆红素、凝血酶原时间、总蛋白下降、凝血酶原活动度升高均有显著性差异 (P <0 .0 5或P <0 .0 1) ,但两种治疗方法间比较各项指标变化程度均无显著性差异。两种方法治疗的不良反应均较轻。结论 中间型、混合型人工肝对重型肝炎肝衰竭患者的肝功能均有肯定的支持效果。
Objective To compare the effects and safety of intermediate (plasma exchange) and mixed (plasma exchange + hemoperfusion) artificial liver support on liver function in patients with liver failure. Methods Fifteen patients with severe hepatitis and liver failure were treated with plasma exchange (17 cases) and plasma exchange + hemoperfusion (34 cases) respectively. The clinical symptoms before and after treatment were observed. The changes of liver and kidney function, blood routine and PT were compared before and after treatment . Results After the plasma exchange and plasma exchange + hemoperfusion, the clinical symptoms of the patients improved to some extent. There was a significant difference of ALT, total bilirubin, direct bilirubin, prothrombin time, total protein and prothrombin activity after the two treatments (P <0.05 or P <0. 0 1), but there was no significant difference between the two treatment methods in comparing the changes of various indexes. Adverse reactions to both treatments were mild. Conclusion The intermediate and mixed artificial liver have positive effect on the liver function of patients with severe hepatitis and liver failure.