【摘要】目的 观察应用新型膜型血浆分离器（Evacure-4）治疗重型肝炎肝衰竭的临床疗效。方法 治疗组22例，对照组15例，2组病例均在内科护肝综合治疗的基础上加用血浆置换（PE）治疗。治疗组在进行PE时应用由乙烯乙烯醇聚合物研制的新型膜型血浆分离器（Evacure-4）；对照组在进行PE时应用由聚砜膜研制的Ps-06膜型血浆分离器。2组病例的目标血浆处理量相同。结果 治疗组存活19例，存活率为86.3%，对照组存活8例，存活率为53.3%。治疗组对肝昏迷的清醒率达90%，而对照组对肝昏迷的清醒率为83.3%。新型膜型血浆分离器（Evacure-4）可有效清除体内的胆红素等代谢废物（P<0.01），与对照组相比，使用Evacure-4进行PE时可以减少患者体内白蛋白等有益成分的丢失，在改善凝血酶原时间方面亦优于Ps-06组（P<0.05）。治疗过程中没有观察到破膜反应的情况。结论 新型膜型血浆分离器（Evacure-4）治疗重型肝炎安全有效。

【Abstract】Objective To observe the clinical effect of a new type of membrane plasma separator（Evacure-4）on severe hepatitis patients with liver failure. Methods 22 cases served as treatment group and 15 cases as control group. Both groups were given similar basic medical treatment and plasma exchange. During the process of plasma exchange, the treatment group was treated with a new type of membrane plasma separator（Evacure-4）which was made from ethylene-vinylalcohol , but the control group was treated with Ps-06 membrane plasma separator made from polyamide. Both groups were exchanged the same target plasma volume. Results 19 cases survived in the treatment group, and the total survival rate was 86.3%; However, in the control group, 8 cases survived and the total survival rate was 53.3%. The conscious rate of hepatic coma was 90% in the treatment group, however, in the control group was 83.3%. The new type of membrane plasma separator（Evacure-4）can effectively remove metabolite including bilirubin and so on（P<0.01）. To contrast with Ps-06, using Evacure-4 to carry out plasma exchange not only can reduce the loss of albumin, but can improve prothrombin time better. During the process of treatment, the side effect of rupture of red cells wasn't found. Conclusion It is available and safe using the new type of membrane plasma separator（Evacure-4）to treat patients with severe hepatitis.