血浆置换对肝衰竭的治疗作用及影响因素研究.docVIP

血浆置换对肝衰竭的治疗作用及影响因素分析 中文摘要 目的探讨血浆置换术对肝衰竭治疗的临床效果及相关影响因素。 方法 回顾性研究我院2012年1月?2014年9月应用血浆置换治疗的90例肝衰竭 患者的相关临床资料，观察血浆置换治疗后的临床疗效、并发症的改善情况、肝功 能 生化指标的变化，并分析影响其疗效的相关因素。实验数据用〒土S表示，计量资料 采用t检验进行比较，计数资料采用戏检验或Fisher确切概率法，P0.05考虑差异有 统计学意义。 结果患者经过血浆置换治疗后临床症状有明显好转，肝功能指标ALT(前 494.78±706.03U/L 后 100」2±136.62U/L)、AST(前 362.23±353.98U/L 后 99.46± 71.95U/L)、TBiK 前 465.90+126.26gmol/L后 263.35+146.41 ^imoVL)均降低(P0.05)； CHE (前3421.87+1354.15U/L后5587.2l±759.02U/L )、PTA (前34.55+12.84%后 61.02±28.64%)均升高(PvO.05)。90例肝衰竭患者行血浆置换治疗共274例次，其中 10例次出现不良反应，总发生率为3.6%,予以对症治疗后缓解均完成治疗；其中 63例患者有效，27例患者无效，总有效率70%o 结论血浆置换在治疗肝衰竭中有重要价值，是治疗肝衰竭安全、有效的手段。其 中发病年龄、临床分期(晚期)、有肝硬化、有并发症、治疗前血清TBiK CHE、 PTA水平是影响疗效的因素。 矢键词 血浆置换；肝衰竭；影响因素 Analysis on the effect and influence factors of plasmaexchange in the treatment of patients with liver failure Abstract Objective To evaluate the clinical effect and influence factors of plasma exchange treatment for liver failure. Methods A retrospective analysis 90 cases of liver failure patients with plasma exchange from January 2012 to September 2014. Clinical symptoms, improvement of complications, changes in liver function markers were observed after plasma exchange, and the influential factors for treatment efficacy were analyzed. Experimental data were expressed x 土S, measurement data were using T test. Significance was assessed with chi-square tests or Fishers exact test. A p-value of 0.05 was considered statistically significant. Results After plasma exchange, patients clinical symptoms improved obviously, ALT (before 494.78 ± 706.03U / L after 100」2 ± 136.62 U / L), AST (before 362.23 ± 353.98U / L after 99.46 ± 71.95U / L), TBil (before 465.90 ± 126.26gmol / L after 263.35 ± 146.41 gmol / L) were lower (P 0.05). CHE (before 3421.87 土 1354.15 U / L after 5587.21 ± 759.02U / L), PTA (before34.55 ± 12.84% after 61.02 ± 28.64% ) were increased (P 0.05). 90 cases of patients with plasma exchange treated for 274 cases, including ten cases of adverse reactions, the overall incidence was 3.