连续白蛋白循环吸附系统用于危重症合并肝衰竭患者治疗的探索

中国血液净化

连续白蛋白循环吸附系统用于危重症合并肝衰竭患者治疗的探索

郑世翔邹志强翁钦永

福建医科大学附属协和医院重症医学科

收稿日期:2011-12-26 出版日期:2012-08-12 发布日期:2012-12-24

The study of continuous albumin circulating absorbent system as the treatment for critically ill patients with liver failure

ZHENG Shi-Xiang, ZOU Zhi-Qiang, WENG Qin-Yong

Received:2011-12-26 Online:2012-08-12 Published:2012-12-24

摘要/Abstract

摘要： 目的探讨连续白蛋白循环吸附系统(continuous albumin circulating absorbent system，CACAS)用于危重症合并肝衰竭患者治疗的疗效及安全性。方法 30例危重症合并肝衰竭患者行CACAS治疗，监测治疗前后及治疗结束后12h患者生命征、肝功能、凝血功能变化，并经行统计学分析。结果治疗结束后患者血胆红素水平较治疗前明显下降(治疗前后血总胆红素485.46土34.85 靘ol/l比305.89土43.54 靘ol/L P＜0.01，结合胆红素293.62土25.67 靘ol/L比190.85土32.13 靘ol/L P＜0.01，游离胆红素212.98土16.18 靘ol/L比159.70土23.57 靘ol/L P＜0.01），凝血酶原活动度明显上升(治疗前后凝血酶原活动度42%土8%比80%土3% P＜0.01），患者神志均转清，其他指标治疗前后无显著变化，治疗结束后12h患者所有指标较治疗结束时无明显改变。结论 CACAS系统用于危重症合并肝衰竭患者的治疗有良好的疗效及安全性，是危重症肝衰竭患者进行人工肝治疗的一个良好的选择。【关键词】中图分类号：R318.14 文献标识码：A doi:10.3969/j.issn.1671-4091.2012.08.00

关键词: 危重症, 肝衰竭, 连续白蛋白循环吸附系统, 疗效, 安全性

Abstract: 【Abstract】 Objective To investigate the efficacy and safety of applying Continuous Albumin Circulating Absorbent System (CACAS) in treatment for critically ill patients with liver failure. Method Thirty critically ill patients with liver failure were treated with CACAS. Patients’ vital signs, liver function, coagulation changes were compared before and after the treatment, and after termination of the treatment for 12h. Results After the treatment, serum bilirubin level (485.46±34.85 μmol/L before treatment, and 305.89±43.54 μmol/L after treatment; P＜0.01), conjugated bilirubin (293.62±25.67 μmol/L before treatment, and 190.85±32.13 μmol/L after treatment; P＜0.01), unconjugated bilirubin (212.98±16.18 μmol/L before treatment, and 159.70±23.57 μmol/L after treatment; P＜0.01) decreased significantly, and prothrombin activity (42±8% before treatment, and 80±3% after treatment; P＜0.01) increased significantly. Consciousness turned to be clear in all patients. Changes of other indicators were insignificant. There were no significant changes of the parameters immediately after treatment and after termination of treatment for 12h. Conclusion CACAS system has ideal efficacy and safety when used in treatment for critically ill patients with liver failure, thus is a choice way of artificial liver as the treatment for liver failure.

Key words: Critically ill, Liver failure, Continuous albumin circulating absorbent system, Efficacy, Safety

郑世翔邹志强翁钦永. 连续白蛋白循环吸附系统用于危重症合并肝衰竭患者治疗的探索[J]. 中国血液净化.

ZHENG Shi-Xiang, ZOU Zhi-Qiang, WENG Qin-Yong. The study of continuous albumin circulating absorbent system as the treatment for critically ill patients with liver failure [J]. Chinese Journal of Blood Purification.