摘要
目的:分析血浆置换(PE)联合连续性血液滤过(CVVH)对急性肝衰竭的治疗作用及患者炎性介质等指标的影响。方法:选择笔者所在医院2013年7月-2018年7月急性肝衰竭患者108例,根据数字表法随机分两组,每组54例,对照组的患者给予常规方法治疗,观察组在该基础上增加PE联合CVVH。比较两组肝功能指标、APACHEⅡ评分、治疗前后白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)等炎性介质及治疗效果。结果:治疗后观察组肝功能指标、APACHEⅡ评分低于对照组(P<0.05)。治疗前两组IL-6、TNF-α、hs-CRP比较差异无统计学意义(P>0.05),而治疗后两组IL-6、TNF-α、hs-CRP均显著降低,且观察组的炎性介质水平低于对照组,差异均有统计学意义(P<0.05)。观察组总有效率高于对照组,差异有统计学意义(P<0.05)。结论:常规方法联合PE联合CVVH对于急性肝衰竭的治疗效果确切,可有效清除炎性介质,改善肝功能,改善患者的预后。
Objective:To analyze the therapeutic effect of plasma exchange(PE)combined with continuous ven-venous hemofiltration(CVVH)on acute liver failure and inflammatory mediators.Method:A total of 108 patients with acute liver failure in our hospital from July 2013 to July 2018 were selected and randomly divided into two groups according to the random number method,with 54 cases in each group.The patients in the control group were given conventional treatment,and the observation group was added with PE combined with CVVH.The indexes of liver function,APACHEⅡscore,interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),hypersensitive C-reactive protein(hs-CRP)and other inflammatory mediators before and after treatment and the therapeutic effect were compared between the two groups.Result:The liver function index and APACHEⅡscore after treatment of the observation group were lower than those of the control group,the differences were statistically significant(P<0.05).Before treatment,the levels of inflammatory mediators such as IL-6,TNF-αand hs-CRP in the two groups were compared,and there were no significant differences(P>0.05).After treatment,the levels of IL-6,TNF-αand hs-CRP in the two groups were significantly decreased,while the level of inflammatory mediators in the observation group was lower than those in the control group,the differences were statistically significant(P<0.05).The total effective rate of the observation group was higher than that of the control group,the difference was statistically significant(P<0.05).Conclusion:The conventional method combined with PE combined with CVVH is effective in the treatment of acute liver failure,which can effectively remove inflammatory mediators,improve liver function and improve the prognosis of patients.
作者
丘永芳
QIU Yongfang(The Second Hospital of Longyan,Longyan 364000,China)
出处
《中外医学研究》
2020年第31期137-139,共3页
CHINESE AND FOREIGN MEDICAL RESEARCH
