人工肝PDF与PE_CHDF在晚期肝衰竭治疗中的疗效对比

人工肝PDF 与PE +CHDF 在晚期肝衰竭治疗中的疗效对比

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周观林1，张伦理2，刘春文1，杨沛华1，张

琼3，谢志军3

（1．赣州市第五人民医院肝病科，江西

赣州

341000；2．南昌大学第一附属医院感染科，江西

南昌

330000；

3．赣南医学院第一附属医院消化内科，江西赣州

341000）

摘

要：目的：评价人工肝血浆滤过透析（PDF ）模式及人工肝血浆置换（PE ）+血液滤过透析（CHDF ）模式在晚期

肝衰竭患者中的疗效对比。方法：选取肝衰竭晚期患者40例，

随机均分为观察组和对照组；观察组在内科综合治疗基础上给予PDF 治疗，对照组在内科综合治疗基础上给予PE +CHDF 治疗，比较两组在治疗前、后临床肝功能生化的改善情况及对临床治疗3个月病死率的影响。结果：两组治疗前生化治疗比较无差别（P ＞0．05），两组治疗后比较，对照组较观察组改善明显（P ＜0．05），两组3个月死亡率相同，无统计学意义。结论：晚期肝衰竭患者在内科综合治疗基础上配合PE +CHDF 治疗与配合PDF 治疗相比，能获得更好的肾功能改善及脱水效果，相近的肝功能指标改善明显，但在节约治疗时间及治疗成本的控制方面PDF 更有优势。两组患者3个月病死率相同。

关键词：人工肝血浆滤过透析；人工肝血浆置换+血液滤过透析；晚期肝衰竭；疗效中图分类号：Ｒ575．3

文献标志码：A

文章编号：1001－5779（2014）04－0527－03

Efficacy Comparison between Artificial Liver PDF and PE +CHDF in the Treatment of Late Liver Failure

ZHOU Guan-lin 1，ZHANG Lun-li 2，LIU Chun-wen 1，YANG Pei-hua 1，ZHANG Qiong 3，XIE Zhi-jun 3

（1．Dept．of Hepatopathy ，the Fifth People＇s Hospital of Ganzhou ，Ganzhou ，Jiangxi 341000；2．Dept．of Infectious Disease ，the First Affiliated Hospital of Nanchang University ，Nanchang ，Jiangxi 330000；3．Dept．of Gastroenterology ，the First Af-filiated Hospital of Gannan Medical University ，Ganzhou ，Jiangxi 341000）

Abstract ：Objective ：To evaluate and compare the efficacy of the artificial liver Plasma filtration dialysis （PDF ）mode and plasma exchange （PE ）plus continuous hemofiltration dialysis （CHDF ）mode in the treatment of the end-stage liver failure．Methods ：40patients with the end-stage liver failure were selected and randomly divided into observation group and control group ；on the basis of comprehensive treatment the observation group was given PDF medical treatment where-as the control group was given PE plus CHDF therapy．The biochemical improvement of liver function and the three-month mortality before and after the treatment were observed and compared．Ｒesults ：The control group had the better biochemi-cal improvement than observation group （P ＞0．05），but the two groups had the same three-month mortality．Conclusion ：PE plus CHDF therapy on the basis of comprehensive treatment can get a better improvement in renal function and dehy-dration effects than PDF therapy mode ，while there is no difference between the PDF therapy and PE plus CHDF therapy on liver function improvement．But the PDF therapy on the basis of comprehensive treatment can save the therapy time and treatment costs than PE plus CHDF therapy mode．There is no difference between the PDF therapy and PE plus CHDF therapy on the three-month mortality．

Key words ：PDF ；PE plus CHDF ；end-stage liver failure ；efficacy

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725—第34卷第4期赣南医学院学报

Vol ．34NO ．42014年8月JOUＲNAL OF GANNAN MEDICAL UNIVEＲSITY AUG ．2014

*基金项目：江西省科技计划项目，编号：2011ZBBG70042