摘要
目的 观察应用代血浆加白蛋白置换液部分代替血浆进行人工肝血浆置换治疗肝衰竭的疗效.方法 随机选取108例肝衰竭患者,其中用代血浆、白蛋白、平衡液、新鲜血浆治疗患者（研究组）54例,单纯血浆组置换治疗患者（对照组）54例.结果 每次治疗后患者临床症状有不同程度的减轻,乏力、腹胀等症状明显改善,腹水减少,治疗后总胆红素明显下降,丙氨酸氨基转移酶和血氨下降,胆碱酯酶、白蛋白及凝血酶原活动度均上升,与对照组比较,临床疗效差异无统计学意义（P〉0.05）.结论 血浆置换是一种有效的人工肝支持疗法,但早期应用、选用合适的置换液是提高疗效的关键.新鲜冰冻血浆是理想的置换液,在血浆紧缺的情况下,应用代血浆＋白蛋白配制置换液部分代替血浆进行人工肝血浆置换治疗肝衰竭也有明显疗效,值得临床进一步应用.
Objective To observe the curative effect of plasma substitute and albumin instead of some plasma in artificial liver plasma exchange treatment of liver failure. Methods 108 cases of liver failure patients were randomly selected. Half of these patients were access to a treatment of plasma exchange fluid consisting of plasma substitute, albumin, equilibrium solution and fresh plasma, and half of them were access to traditional plasma exchange treatment. Results After plasma exchange therapy, all the patients showed alleviated clinical symptoms, such as fatigue, bloating and etc. Physical and lab examinations showed that ascites was decreased significantly, total bilirubin, alanine aminotransferase, blood ammonia decreased, cholinesterase, albumin, prothrombin activity were increased after treatment. Plasma substitute and albumin replacement treatment did not show any significant differences in terms of the clinical curative effect on liver failure compared with the traditional plasma replacement treatment （ P 〉 0.05 ）. Conclusion Plasma exchange is an effective artificial liver support therapy, and early application of proper replacement fluid is the key to improve the curative effect. Fresh frozen plasma is the ideal replacement fluid. Under the circumstances of lacking of fresh plasma, the plasma substitute ＋ albumin preparation replacement fluid instead of some plasma is an alternative choice for the artificial liver plasma exchange treatment and it is worthy of further clinical application because of its obvious curative efficiency on liver failure.
出处
《中国急救医学》
CAS
CSCD
北大核心
2013年第9期829-831,共3页
Chinese Journal of Critical Care Medicine
关键词
代血浆
白蛋白
置换液
血浆
人工肝
肝衰竭
Plasma substitute
Albumin replacement fluid
Plasma
Artificial liver
Liver failure
