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目的探讨血液灌流治疗后肝衰竭患者肝纤维化进展情况。方法选取2012年3月—2015年9月在本院住院的37例急性肝衰竭患者,根据不同治疗方案分为治疗组和对照组,治疗组14例患者在内科治疗基础上联合血液灌流治疗,对照组23例患者只采用内科治疗,分别予治疗2~4周,比较治疗前后生化指标、凝血功能及肝纤维化指标变化,随访1年间两组患者肝纤维化指标进展情况。计量资料采用t检验,计数资料采用χ~2检验,P<0.05为差异有统计学意义。结果治疗组住院时间低于对照组,两组患者治疗后TBil、IBil、ALT均明显下降,血小板明显改善,随访过程中,治疗组肝纤维化指标上升速度低于对照组,对比差异均有统计学意义(均P<0.05)。治疗组和对照组复发比例分别为21.4%、30.4%,复发比例对比差异有统计学意义(P<0.05)。结论血液灌流治疗有助于延缓急性肝衰竭后肝纤维化进展。
Objective To investigate the progress of hepatic fibrosis in patients with liver failure after hemoperfusion. Methods Thirty-seven patients with acute liver failure hospitalized in our hospital from March 2012 to September 2015 were divided into treatment group and control group according to different treatment plans. 14 patients in treatment group were treated with hemoperfusion based on medical treatment, 23 patients in the control group were treated with medical treatment only for 2 to 4 weeks respectively. The biochemical indexes, coagulation function and indexes of liver fibrosis were compared before and after treatment. The progress of liver fibrosis index in two groups were followed up for one year. Measurement data using t test, count data using χ ~ 2 test, P <0.05 for the difference was statistically significant. Results The hospitalization time of the treatment group was lower than that of the control group. The TBil, IBil and ALT were significantly decreased and the platelets were significantly improved after treatment in both groups. During the follow-up, the index of liver fibrosis in the treatment group increased at a slower rate than the control group Significance (both P <0.05). The recurrence rates of the treatment group and the control group were 21.4% and 30.4%, respectively, with significant difference (P <0.05). Conclusion Hemoperfusion can help delay the progression of liver fibrosis after acute liver failure.