中国血液净化

中国血液净化 ›› 2017, Vol. 16 ›› Issue (11): 771-773.doi: 10.3969/j.issn.1671-4091.2017.011.014

• 人工肝 • 上一篇    下一篇

白蛋白透析联合胆红素吸附治疗心脏术后急性肝衰竭临床研究

裴锋博1,龚黎1,陈祖君1,吴慧1,刘红1,姚垚1,张志鹏1,施野1,路天怡1,杜鹃1,杨立猛1,郑哲1,张海涛1   

  1. 1.中国医学科学院北京协和医学院国家心血管病中心阜外医院
  • 收稿日期:2017-06-15 修回日期:2017-10-09 出版日期:2017-11-12 发布日期:2017-10-27
  • 通讯作者: 郑哲zhengzhe@fuwai.com E-mail:mptpicu@hotmail.com

Clinical study of albumin dialysis combined with bilirubin adsorption in the treatment of acute liver failure after cardiac surgery

  • Received:2017-06-15 Revised:2017-10-09 Online:2017-11-12 Published:2017-10-27

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摘要： 目的研究白蛋白透析联合胆红素吸附对心脏术后急性肝衰竭治疗的安全性及有效性。方法回顾性分析阜外医院自2014 年8 月～2016 年12 月期间运用白蛋白透析联合胆红素吸附治疗的7 例心脏术后急性肝衰竭患者数据。记录患者治疗前后肝功能及胆红素、凝血功能等指标。结果7 例患者全部肝功能好转并转出重症监护室,6 例患者顺利出院，1 例患者合并院内感染死亡。治疗前后患者谷丙转氨酶(alanine aminotransferase，ALT)及谷草转氨酶(aspartate aminotransferase，AST)分别由(632±197)U/L 及(384±125)U/L 下降至(516±149)U/L 和(277±112)U/L,有统计学差异(t=4.692，P=0.017；t=3.012，P=0.033)。治疗前总胆红素(759±144)μmol/L,直接胆红素(544±115)μmol/L，治疗后总胆红素(441±97)μmol/L，直接胆红素(299±67)μmol/L(t=8.240，P＜0.001；t=6.119，P=0.001)。治疗期间患者循环稳定，无严重并发症。结论白蛋白透析联合胆红素吸附对心脏术后急性肝衰竭患者是一种安全有效的方法。

关键词: 白蛋白透析, 胆红素吸附, 心脏外科, 肝衰竭

Abstract: Objective To evaluate the safety and efficacy of albumin dialysis combined with bilirubin adsorption in the treatment of acute liver failure after cardiac surgery. Methods Seven patients with acute liver failure after cardiac surgery treated in Fuwai Hospital between Aug. 2014 to Dec. 2016 were retrospectively analyzed. Results of liver enzymes, bilirubin and blood coagulation tests were recorded before and after treatment. Results Liver function recovered in all the 7 patients, of whom 6 discharged from hospital and one died of nosocomial infection. After the treatment, alanine aminotransferase (ALT) decreased from (632±197) U/L to (516±149) U/L (t=4.692, P=0.017), aspartate aminotransferase (AST) decreased from (384±125)U/L to (277±112) U/L (t=3.012, P=0.033), total bilirubin from (759±144) μmol/L to (441±97) μmol/L (t=8.240, P＜0.001), and direct bilirubin from (544±115) μmol/L to 299±67 μmol/L (t=6.119, P=0.001). Circulation status of the patients was stable during the treatment, and no serious complications happened. Conclusion Albumin dialysis combined with bilirubin adsorption is a safe and effective method for acute liver failure after cardiac surgery.

Key words: Albumin dialysis, bilirubin adsorption, cardiac surgery, liver failure