组合式连续性静脉-静脉血浆滤过-胆红素吸附治疗肝衰竭患者的疗效与护理观察*

doi:10.3969/j.issn.1672-5069.2014.06.013

Abstract

Abstract: Objective To observe the efficacy and nursing care of combined continuous veno-venous hemofiltration and bilirubin adsorption therapy in patients with hepatic failure. MethodsThe effectiveness, treatment duration,complication incidence,treatment costs and nursing workload were compared between 32 patients treated with combined continuous veno-venous hemofiltration and bilirubin adsorption therapy and 44 patients treated with sequential plasma adsorption and continuous renal replacement treatment. Results On the 7th day of treatment,the efficacy of combined continuous veno-venous hemofiltration and bilirubin adsorption therapy were superior to that of sequential plasma adsorption and continuous renal replacement treatment [total bilirubin （161.1±45.1）vs.（218.9±58.5） μmol/L,bile acid（130.5±60.5） vs. （198.6±49.6） μmol/L,aspartate aminotransferase （152.4±96.3） vs. （252.4±169.1） IU/L,alanine transaminase （147.2±72.6） vs.（220.1±110.3） IU/L,international normalized ratio （1.6±0.4） vs. （1.6±0.4）,preparing time （1.0±0.1） vs. （1.3±0.1） h,treatment duration （7.2±0.5） vs. （11.1±0.7） h and treatment costs（11.0±1.0） vs.（13±1.0） grand RMB,P<0.05 for all]. Complication incidence in both groups showed no difference. ConclusionCombined continuous veno-venous hemofiltration and bilirubin adsorption therapy has preferable efficacy in treatment of patients with liver failure,and effectively reduces the nursing workload and treatment costs.

Key words: Liver failure, Combined continuous veno-venous hemofiltration and bilirubin adsorption therapy, Continuous renal replacement treatment, Efficacy, Nursing care

Li Moqi, Shou Yuli, Pu Linjuan. Efficacy of combined continuous veno-venous hemofiltration and bilirubin adsorption therapy in patients with hepatic failure[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2014, 17(6): 611-615.

References

[1] 中华医学会感染病学分会肝衰竭与人工肝学组.肝衰竭诊治指南. 实用肝脏病杂志,2013,16（3）:210-216.
[2] Lehner S,Stemmler HJ,Mück A,et al. Prognostic parameters and risk stratification in intensive care patients with severe liver diseases. J Gastrointestin Liver Dis,2010,19（4）:399-404.
[3] 王质刚,段钟平. 血液净化模式与临床应用. 北京:北京科学技术出版社,2008:187-199.
[4] 刘雯. MELD 评分评估血浆置换治疗慢性乙型重型肝炎的疗效. 实用肝脏病杂志,2011,14（1）:29-30.
[5] 段学章,辛绍杰. 人工肝在肝衰竭治疗中的应用. 中华肝脏病杂志,2012,20（6）:411-413.
[6] Tritto G,Davies NA,Jalan R. Liver replacement therapy. Semin Respir Crit Care Med,2012,33（1）:70-79.
[7] Wang Z,Cao Y,Wei H,et al. Bilirubin adsorption properties of water-soluble adsorbents with different cyclodextrin cavities in plasma dialysis system. Colloids Surf B Biointerfaces,2012,90: 248-253.
[8] 朱冬冬,龚德华. 组合式连续性静脉-静脉血浆滤过-胆红素吸附系统在高胆红素血症治疗中的应用.肾脏病与透析肾移植杂志,2011,20（3）:204-211.
[9] 刘传苗,徐静,张莉,等.血浆置换治疗肝衰竭临床分析.实用肝脏病杂志,2012,15（3）:241-243.
[10] McLeod BC. Plasma and plasma derivatives in therapeutic plasmapheresis. Transfusion,2012,52 （Suppl 1）:38S-44S.
[11] Vaid A,Chweich H,Balk EM,et al. Molecular adsorbent recirculating system as artificial support therapy for liver failure:a meta-analysis. ASAIO J,2012,58（1）:51-59.
[12] Bachir NM,Larson AM. Adult liver transplantation in the United States. Am J Med Sci,2012,132（31）:462-469.
[13] Rademacher S,Oppert M,Jorres A. Artificial extracorporeal liver support therapy in patients with severe liver failure. Expert Rev Gastroenterol Hepatol,2011,5（5）:591-599.
[14] Banares R,Nevens F,Larsen FS,et al. Extracorporeal albumin dialysis with the molecular adsorbent recirculating system in acute-on-chronic liver failure:the RELIEF trial. Hepatology,2013,57（3）:1153-1162.
[15] Bakos A,Rikker C,Tóvárosi S,et al. Therapeutic effect of the latest extracorporal elimination procedure （Prometheus treatment） in acute liver failure caused by intoxication. Orv Hetil,2007,148（42）:1981-1988.
[16] 郑三菊,郑化芝,凌红芬,等. 血浆置换术治疗慢加急性肝衰竭50例. 实用肝脏病杂志,2012,15（3）:241-243.
[17] 徐文达,喻贵,赵琳, 等. 血浆置换联合持续血液滤过治疗28例急性药物性肝衰竭疗效观察. 实用肝脏病杂志,2010,13（1）: 55-56.
[18] 朱玉成,张建,张德荣,等. 血浆置换联合血浆吸附治疗重型肝炎常见不良反应的临床观察. 实用肝脏病杂志,2010,13（2）: 131-132.
[19] 胡振杰,刘丽霞.持续性肾脏替代治疗适应症与并发症. 中国实用内科杂志,2012,32（6）:415-418.
[20] Kramer L,Kodras K. Detoxification as a treatment goal in hepatic failure. Liver Int,2011,31（3）:1-4.

Efficacy of combined continuous veno-venous hemofiltration and bilirubin adsorption therapy in patients with hepatic failure

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