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目的研究药物性急性肝衰竭治疗措施及有效性。方法药物性急性肝衰竭患者60例,30例为观察组,在保护肝脏,营养支持和对症治疗的基础上血液滤过联合血液灌流。其余30例为对照组,行保肝对症治疗。分析不同治疗方法对药物性急性肝衰竭患者的治疗成功率和生存质量的影响。结果观察组与对照组比较治疗疗效差异有统计学意义(P<0.05)。观察组与对照组在治疗前,ALT、AST、ALP、GGT、TBA、TBIL、DBIL、TP和ALB各指标差异无统计学意义(P>0.05)。治疗后,ALT、AST、ALP、GGT、TBA、TBIL、DBIL、TP、ALB二组间差异有统计学意义(P<0.05)。观察组治疗前后ALT、AST、ALP、TBA、TBIL、DBIL、TP、ALB差异具有统计学意义(P<0.05)。对照组治疗前后ALT、AST、ALP、GGT、TBIL、DBIL、TP、ALB差异具有统计学意义(P<0.05)。观察组与对照组相比,中性粒细胞减少人数较多为7例,对照组仅为1例。其他不良反应如粒细胞减少、腹胀、食欲下降、恶心、发烧、血尿素氮升高的差异无统计学意义(P>0.05)。结论血液滤过联合血液灌流的治疗措施能促进药物性急性肝衰竭患者肝功能指标的恢复。并且观察组采取血液滤过联合血液灌流与保肝对症相比,不会影响患者的生存质量。
Objective To study the therapeutic measures and effectiveness of drug-induced acute liver failure. Methods Sixty patients with drug-induced acute liver failure and 30 patients as observation group were given hemofiltration combined with hemoperfusion on the basis of liver protection, nutritional support and symptomatic treatment. The remaining 30 cases for the control group, the line of symptomatic treatment of liver. The effects of different treatment methods on the success rate and quality of life of patients with drug-induced acute liver failure were analyzed. Results There was significant difference in curative effect between observation group and control group (P <0.05). There was no significant difference in ALT, AST, ALP, GGT, TBA, TBIL, DBIL, TP and ALB between observation group and control group before treatment (P> 0.05). After treatment, there was significant difference between ALT, AST, ALP, GGT, TBA, TBIL, DBIL, TP and ALB (P <0.05). The difference of ALT, AST, ALP, TBA, TBIL, DBIL, TP and ALB before and after treatment in the observation group was statistically significant (P <0.05). The difference of ALT, AST, ALP, GGT, TBIL, DBIL, TP and ALB before and after treatment in the control group was statistically significant (P <0.05). Compared with the control group, the observation group and the control group, the larger the number of neutropenia in 7 cases, the control group was only 1 case. Other adverse reactions such as neutropenia, bloating, loss of appetite, nausea, fever, blood urea nitrogen increased no significant difference (P> 0.05). Conclusion Hemofiltration combined with hemoperfusion can promote the recovery of liver function in patients with drug-induced acute liver failure. And the observation group to take hemofiltration combined with hemoperfusion and hepatoprotective syndrome, will not affect the quality of life of patients.