小剂量血浆置换联合血浆灌流治疗妊娠期急性脂肪肝疗效观察.docVIP

小剂量血浆置换联合血浆灌流治疗妊娠期急性脂肪肝疗效观察 　　【摘要】目的 研究小剂量血浆置换（PE）联合血浆灌流（PP）对妊娠期急性脂肪肝（AFLP）的临床疗效。方法将13例进行常规剂量PE的AFLP患者设为对照组，12例进行小剂量PE联合PP的AFLP患者设为治疗组，对比两组人工肝治疗前后的肝功能指标变化及预后。结果治疗后，两组的总胆红素（TBIL）、直接胆红素（DBIL）、谷丙转氨酶（ALT）、谷草转氨酶（AST）水平以及对照组治疗后凝血酶原时间（PT）值均较治疗前明显改善，差异有统计学意义（P0.05）；治疗后两组上述指标的检测值比较差异无统计学意义（P0.05）。对照组10人经治疗后治愈出院，治愈率为76.9%，治疗组11人治愈出院，治愈率为91.7%，两组治愈率比较差异无统计学意义（P=0.5930）。结论小剂量PE联合PP不但减少了血浆使用量，而且在改善AFLP患者肝功能、清除代谢产物方面与常规剂量PE效果相似。 　　【关键词】妊娠期急性脂肪肝；血浆灌流；小剂量；血浆置换 　　中图分类号：R714.2 文献标识码：ADOI：10.3969/j.issn2015.06.011 　　Observation of efficacy of low dose plasma exchange combined with 　　plasma perfusion for patients with acute fatty liver of pregnancy 　　MO Zucong，XIONG Bing，HUANG Zhai，QIN Wenbo，HUANG Peng，LU Zheng 　　（Department of Intensive Care Unit，The People’s Hospital of Guangxi 　　Zhuang Autonomous Region，Nanning 530000，Guangxi，China） 　　【Abstract】ObjectiveTo investigate clinical efficacy of low dose plasma exchange（PE） combined with plasma perfusion（PP） in patients with acute fatty liver of pregnancy（AFLP）.Methods13 cases of AFLP treating with normal dose of PE were selected as control group，and 12 cases treating with low dose of PE combined with PP as treatment group.Then，changes of liver function indexes before and after artificial liver treatment as well as the prognosis were compared between groups.Results After treatment，serum levels of total bilirubin（TBIL），direct bilirubin（DBIL），alanine aminotransferase（ALT），aspartate transaminase（AST） of the two groups as well as value of prothrombin time（PT） of the control group significantly improved，difference was statistically significant（P0.05）.There was no significant changes in the abovementioned indexes of the two groups after treatment（P0.05）.10 cases in the control group left hospital after being cured，cure rate was 76.9%.11 cases in the treatment group left hospital after being cured，and cure rate was 91.7%.Difference of the cure rates of the two groups was not statistically significant（P=0.5930）.ConclusionLow do