第一临床医学院知识库

目的 探讨肝功能衰竭治疗过程中采用血浆置换术的临床效果及相关的影响因素。
方法 收集 2015 年 1 月至 2017 年 9 月在我院重症医学科使用血浆置换治疗的 90 例肝功能衰竭患者的临床治疗相关资料，对比采用血浆置换治疗前后，患者的临床治疗效果，以及患者并发症的改善情况、肝功能各项指标的变化情况，进而对影响治疗肝功能衰竭疗效的相关因素进行分析。本研究均数±标准差表示分析的实验数据，对资料的计数采用 χ ² 检验，采用 t 检验进行料比较计量，P<0.05 差异有统计学意义。
结果 所有进行血浆置换治疗的 90 例肝功能衰竭患者，共进行 274 例次血浆置换治疗，其中出现不良反应患者 10 例次，不良反应的总发生率为 3.6%，予以对症治疗后缓解，均完成治疗；90 例患者中肝功能衰竭治疗有效 63 例，肝功能衰竭治疗无效 27 例，总治疗有效率 70%。
结论 在治疗肝功能衰竭中，血浆置换具有非常重要的实用价值，能够有效的、安全的治疗肝功能衰竭。影响血浆置换治疗肝功能衰竭治疗效果的因素有发病年龄、有肝硬化、有并发症、临床分期（晚期）、CHE、治疗前血清 TBil、PTA水平等因素。

Objective To investigate the clinical effect and related factors of plasma exchange in the treatment of liver failure.
Methods The clinical data of 90 patients with liver failure were collected from January 2015 to September 2017 in the Department of critical medicine in our hospital. The clinical therapeutic effects of the patients before and after the treatment of plasma exchange were compared, the improvement of the patients' complications and the changes of various indexes of liver function were compared. The related factors influencing the curative effect of liver failure were analyzed. In this study, the experimental data of average ±Standardize were used to express the analysis of the data. The data were counted by χ ² test, and the t test was used to compare the data. The difference of  P <0.05 was statistically significant.

Results All 90 patients with liver failure treated with plasma exchange were treated with 274 cases of plasma exchange, including 10 cases of adverse reactions, the total incidence of adverse reactions was 3.6%, and the treatment was completed after symptomatic treatment. 63 cases of liver failure were effective in 90 cases, and 27 cases of liver failure were invalid. 27 cases were
invalid. The effective rate of total treatment was 70%.
Conclusion Plasma exchange has a very important practical value in the treatment of liver failure, and it can effectively and safely treat liver failure. The factors affecting the treatment of liver failure were age of onset, cirrhosis, complications, clinical stage (late stage), CHE, serum TBil and PTA levels before treatment.