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The clinical research of hybrid bioartificial liver for blocking the SIRS to MODS stage in patients with fulminant liver failure
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- Author:
- No author available
- Journal Title:
- JOURNAL OF EMERGENCY MEDICINE
- Issue:
- 1
- DOI:
- 10.3760/j.issn:1671-0282.2002.01.004
- Key Word:
- 混合型生物人工肝;重型肝炎;多器官功能障碍综合征
Abstract： 目的通过混合型生物人工肝治疗对急性或亚急性肝炎肝功能衰竭患者血清促炎性细胞因子和内毒素的清除作用,探讨其减轻全身炎症反应综合征(SIRS)的程度并降低多器官功能障碍综合征(MODS)发生的效果.方法组合型生物人工肝由血浆置换和猪肝细胞型生物人工肝构成.5例重症肝炎肝功能衰竭患者(急性重型3例和亚急性重型2例)各行组合型生物人工肝治疗1次,时间约10～12 h,于治疗前、治疗中、治疗后分3个不同时段取血分别测肝功能、肾功能、血氨、血清TNF-α、IL-6及内毒素水平,并监测血液动力学指标和神经系统症状.结果 3例治疗前伴肝性脑病患者昏迷程度减轻.与治疗前比较,血清总胆红素(TBIL)、TNF-α、IL-6及血清内毒素水平明显降低(P＜0.01),胆碱脂酶(CHE)、凝血酶原活动度显著升高(P＜0.01).治疗前合并2种器官衰竭者4例,3种器官衰竭者1例.治疗后未再继续发展.其中2例患者痊愈(2种器官衰竭),1例1周后成功实施肝移植(3种器官衰竭),其余2例分别存活8日和21日,治疗后有效为4/5,存活为3/5.结论混合型生物人工肝能明显的降低重症肝炎急性期血清促炎性细胞因子和内毒素的水平,是遏制从SIRS到MODS病理发展、促进衰竭脏器恢复的有效手段.
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