摘要
目的探讨羟乙基淀粉部分代替血浆在人工肝支持系统中治疗肝衰竭的应用方法及安全性。方法 45名肝衰竭患者应用全血浆、低比例(≤25%)或高比例(>25%)羟乙基淀粉代替血浆进行血浆置换或血浆置换联合吸附人工肝治疗,共124人次,比较各种方法治疗前后生化指标变化及副反应发生情况。结果用羟乙基淀粉部分代替血浆进行人工肝治疗后,患者的肝功能指标可显著改善,其中经血浆置换联合吸附人工肝治疗对部分肝功能指标的改善强于单纯血浆置换方法,并且羟乙基淀粉应用比例≤25%总置换量时对胆红素等的清除效果更显著,对机体的不良影响更小。结论在人工肝治疗肝衰竭过程中可低比例应用羟乙基淀粉代替血浆,以在一定程度上缓解临床用血的压力。
Objective To examine the application of hydroxyethyl starch as a plasma expander in the artificial liver support system（ALSS）treatment of patients with liver failure and assess its safety.Methods Forty-five liver failure patients were subjected to plasma exchange（PE）or PE＋plasme absorption（PA）treatment（n=124）by using plasma or hydroxyethyl starch（HES,≤25% or25%）.The biochemical indices and adverse effects were compared before and after the treatment.Results The liver function profile was significantly improved in the patients in whom HES was partially substituted for plasma during the ALSS treatment（P0.05）.The clinical effects in the PE＋PA group were superior to those in the PE group.In addition, the serum bilirubin was significantly cleared and the adverse effects were decreased when the proportion of HES to the plasma was below 25% in the treatment of plasma exchange combined with absorption.Conclusion HES of small quantity can be used as the plasma expander in ALSS for the treatment of patients with liver failure,which is helpful to alleviate the clinical pressure of shortage in plasma supply.
出处
《华中科技大学学报（医学版）》
CAS
CSCD
北大核心
2013年第6期681-684,693,共5页
Acta Medicinae Universitatis Scientiae et Technologiae Huazhong
关键词
肝衰竭
羟乙基淀粉
血浆置换
血浆吸附
人工肝支持系统
liver failure
hydroxyethyl starch
plasma exchange
plasma absorption
artificial liver support system
