【摘要】 [背景]观察双重血浆分子吸附系统(DPMAS)在急性肝衰竭患者中的应用疗效.[病例报告]选择2016年1月—2017年12月间收治的急性肝衰竭患者28例,分为对照组和DPMAS组,给予DPMAS组15例内科常规治疗加DPMAS治疗,给予对照组13例内科常规治疗,观察7d内2组治疗前后临床症状及体征改善情况和血常规、肝功能、C-反应蛋白指标变化情况.DPMAS组腹胀、恶心、呕吐等临床症状缓解较快,但7d后与对照组比较差异无统计学意义(P>0.05),而皮肤黄染与对照组比较差异有统计学意义(P<0.01);DPMAS组治疗后胆红素、C-反应蛋白及白细胞计数与同组治疗前比较差异有统计学意义(P<0.05),且与对照组治疗后比较差异亦有统计学意义(P<0.05);DPMAS组治疗后血红蛋白与血小板指标与同组治疗前比较差异无统计学意义(P>0.05),且与对照组治疗后比较差异亦无统计学意义(P>0.05).[讨论]DPMAS可清除胆红素及炎症介质,改善临床预后,对血液中血红蛋白及血小板等有形成分未见有影响,治疗急性肝衰竭效果良好.更多还原

【Abstract】 BACKGROUND To observe the curative effects of double plasma molecular adsorption system(DPMAS)in patients with acute liver failure.CASE REOPORTS 28 patients with acute liver failure were selected from January 2016 to December 2017 and divided into the control group and DPMAS group.15 patients in DPMAS group were treated with routine medical treatment plus DPMAS treatment,13 patients in the control group were treated with routine medical treatment.The improvement of clinical symptoms and signs and the changes of blood routine,liver function and C-reactive protein index of the two groups before and after the treatment were observed within 7 days.The clinical symptoms of abdominal distension,nausea and vomiting in DPMAS group were relieved rapidly,however,the difference was not statistically significant after 7 days between the two groups(P>0.05).The improvement of skin yellow dyeing was significantly different from the control group(P<0.01).There were significant differences in bilirubin,C-reactive protein and leukocyte count in DPMAS group before and after the treatment(P<0.05),and the differences were significant compared with the control group after treatment(P<0.05).There was no significant changes in hemoglobin and platelet index in DPMAS group before and after treatment(P>0.05),and there was no significant difference between the two groups after treatment(P >0.05).DISCUSSION DPMAS could remove bilirubin and inflammatory mediators,improve the clinical prognosis and had no effects on hemoglobin and visible components such as platelets in the blood.It was effective in treating acute liver failure.更多还原