血浆置换不同补充时机对药物性肝损伤疗效的影响

发布时间：2018-02-17 06:26

本文关键词： 药物性肝损伤血浆置换时机替补液　出处：《中国药房》2015年35期 　论文类型：期刊论文

【摘要】：目的:探讨血浆置换不同补充时机对药物性肝损伤疗效的影响。方法:96例药物性肝损伤患者,按照随机数字表法分为A、B、C组,各32例。所有患者在常规治疗基础上进行血浆置换治疗。其中,A组患者与血浆置换同步进行的替补液为100%新鲜血浆;B组患者与血浆置换同步进行的替补液为:先补充40%生理盐水,再补充60%新鲜血浆;C组患者在血浆置换至离体血液达1个体循环量的12%时,再开始补充替补液,补充顺序为先补充40%生理盐水,再补充60%新鲜血浆。观察各组患者治疗前后的临床症状及体征、肝脏功能和凝血酶原活动度。结果:采用血浆置换治疗药物性肝损伤均可获得较好的疗效,但C组患者临床症状及体征消失的时间显著短于A组和B组,B组又显著短于A组,组间比较差异均具有统计学意义(P0.05)。3组患者治疗后的总胆红素、凝血酶原活动度、白蛋白水平均显著优于治疗前,差异具有统计学意义(P0.05),且C组优于A、B两组,B组优于A组,组间比较差异均具有统计学意义(P0.05)。3组患者治疗后的丙氨酸转氨酶和天冬氨酸转氨酶水平显著下降,与治疗前比较差异具有统计学意义(P0.05),且B、C组显著优于A组,差异具有统计学意义(P0.05),而B、C两组相似,差异无统计学意义(P0.05)。结论:在不同时机进行血浆置换对药物性肝损伤有着不同的疗效,在血浆置换至离体血液达1个体循环量的12%时,先补充40%生理盐水,再补充60%新鲜血浆的效果较为显著。
[Abstract]:Objective: To investigate the effect of plasma exchange on the curative effect of different time of drug-induced liver injury. Methods: 96 cases of drug-induced liver injury were randomly divided into A, B, C group, 32 cases in each group. All patients were treated with plasma exchange on the basis of routine treatment. The patients with A plasma exchange synchronization backup solution for 100% B patients with fresh plasma; plasma exchange of liquid substitute: first add 40% saline, add 60% fresh plasma; C patients in vitro blood plasma exchange to 1 individual circulation of 12%, and then began to supplement for rehydration, supplement order for the first of 40% ns, add 60% fresh plasma. Observe the clinical symptoms and signs before and after treatment in patients with the liver function and prothrombin activity. Results: to obtain better curative effect by plasma exchange in the treatment of drug-induced liver injury can be, but group C with Pro The clinical symptoms and signs disappeared time was significantly shorter than that of A group and B group, B group was significantly shorter in the A group, the difference was statistically significant (P0.05) of.3 group patients after total bilirubin, prothrombin activity, serum albumin levels were significantly better than before treatment, the difference was statistically significant (P0.05), and the C group is better than A, B two group, B group than in A group, the difference was statistically significant (P0.05).3 groups after treatment of alanine aminotransferase and aspartate aminotransferase levels decreased significantly, compared with before treatment, the differences were statistically significant (P0.05), and B, C group better than the A group, the difference was statistically significant (P0.05), and B C, the two groups were similar, the difference was not statistically significant (P0.05). Conclusion: plasma exchange in different time has different effect on drug-induced liver injury, in vitro blood plasma exchange to 1 individual circulation volume 12%, first fill The effect of 40% normal saline filling and 60% fresh plasma is more significant.

【作者单位】：南京市江宁区中医医院普外科;
【分类号】：R575

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