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[目的]探讨输注血浆联合连续性静-静脉血液滤过(CVVH)治疗急性肝功能衰竭的疗效、安全性及可行性。[方法]对40例急性肝功能衰竭患者应用输注血浆联合CVVH治疗,通过比较治疗前后患者临床症状、血清总胆红素(TBIL)、白蛋白(ALB)、凝血酶原活动度(PTA)等指标判断临床疗效,观察治疗相关的不良反应及患者耐受情况,判断安全性及可行性。[结果]治疗后患者意识模糊、乏力、纳差、腹胀、黄疸等症状均明显缓解,血清TBIL较治疗前降低,ALB、PTA上升,治疗后近期有效率达70%,不良反应少,未发生大出血、休克等严重并发症,患者耐受良好。[结论]在内科综合治疗的基础上输注血浆联合CVVH治疗可显著改善急性肝功能衰竭患者临床症状及肝功能生化指标,提高近期存活率,且安全可行,具有较高的临床应用价值。
[Objective] To investigate the efficacy, safety and feasibility of transfusion of plasma combined with continuous veno-venous hemofiltration (CVVH) in the treatment of acute liver failure. [Methods] Forty patients with acute liver failure were treated with infusion of plasma and CVVH. The clinical symptoms, serum total bilirubin (TBIL), albumin (ALB), prothrombin activity (PTA) And other indicators to determine the clinical efficacy, treatment-related adverse reactions observed and patient tolerance, to determine the safety and feasibility. [Results] After treatment, the symptoms of patients were vague, fatigue, anorexia, abdominal distension, jaundice and other symptoms were significantly alleviated. Serum TBIL decreased compared with before treatment, ALB, PTA increased, the effective rate was 70% after treatment, with fewer adverse reactions, did not occur Hemorrhage, shock and other serious complications, patients are well tolerated. [Conclusion] The infusion of plasma combined with CVVH can significantly improve the clinical symptoms and liver biochemical indexes and improve the short-term survival rate of patients with acute liver failure, which is safe and feasible. It has high clinical value.