天津医药

• 短篇论著 • 上一篇    下一篇

结肠透析联合人工肝治疗肝衰竭合并肝性脑病临床观察

冯洪玲1,王邦茂2,李谦3,唐克诚3   

  1. 1. 天津医科大学
    2. 天津医科大学总医院
    3. 天津市传染病医院
  • 收稿日期:2011-07-27 修回日期:2011-11-29 出版日期:2012-02-15 发布日期:2012-02-15
  • 通讯作者: 冯洪玲

The efficacy of colon dialysis with integrated traditional Chinese and Western medicine and artificial liver support system in treating liver failure with hepatic encephalopathy

  • Received:2011-07-27 Revised:2011-11-29 Published:2012-02-15 Online:2012-02-15

PDF (PC)

2273

摘要： 目的 观察中西医结合结肠透析联合人工肝支持系统对肝衰竭合并肝性脑病的治疗效果。 方法 将74例肝衰竭合并肝性脑病患者分为治疗组和对照组，两组均接受内科综合治疗及人工肝治疗。治疗组在对照组的基础上，行结肠透析治疗。分别于治疗前及治疗后2周观察患者存活率、临床疗效、肝功能（总胆红素，TBIL）、凝血酶原活动度、血氨等变化。 结果 治疗组存活率为84.21%，较对照组58.33%，差别有统计学意义（χ2＝6.091，P＜0.05）。两组恢复清醒时间治疗组为(32.88±8.34)h，较对照组（45.12±9.68）h，明显缩短，差别有统计学意义（ t=4.171 p<0.01）。两组总有效率，治疗组（78.95%）高于对照组（52.78%）差别有统计学意义（χ2＝5.659，P＜0.05）。与对照组比较，治疗组在胆红素、血氨下降、凝血酶原活动度回升等方面优于对照组（P<0.01）。 结论 中西医结合结肠透析治疗肝衰竭合并肝性脑病疗效显著，可缩短恢复清醒时间，有效降低胆红素、血氨水平、提高凝血酶原活动度，明显提高患者生存率。

关键词: 中西医结合结肠透析, 肝衰竭, 肝性脑病, 人工肝支持系统

Abstract: Objective To investigate the efficacy of colon dialysis therapy with integrated traditional Chinese and Western medicine and artificial liver support system with hepatic encephalopathy. Methods 74 cases of hepatic encephalopathy were divided into two groups: treated group(38 cases) and control group(36 cases) and treated with comprehensive management and artificial liver treatment. The patients in treatment group were treated with colon dialysis therapy on the base of routine treatment. The changes of symptom, prognosis, liver function, PTA, blood ammonia were observed before and after the treatment. ? Results The survival rate in treated group(84.21%) was higher than that in control group(58.33%)(χ2＝6.091，P＜0.05). The recovery period of unconsciousness of patients in treated group (32.88±8.34)h was much shorter than those in control group (45.12±9.68)h (P<0.01). The totle effective rate for hepatic encephalopathy treatment in treated group (78.95%) was much higher than those in control group (52.78%)(χ2＝5.659，P＜0.05). Significant difference of Bil, PTA, and blood ammonia were shown in the treated group(P<0.01) before and after treatment, and between groups after treatment (P<0.01). Conclusion The colon dialysis is effective in hepatic encephalopathy treatment, which can shorten the unconsciousness time, increase the survival rate, decrease the levels of bilirubin and blood, ammonia and shorten prothrombin time.

Key words: colon dialysis therapy with integrated traditional Chinese and Western medicine, liver failure, hepatic encephalopathy, artificial liver support system