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目的 探讨人工肝支持系统 (ALSS)治疗重症肝炎时并发症的发生及防治。方法 日产KM - 880 0血液净化仪对4 8例重症肝炎进行 13 7次治疗 ,其中血浆置换 (PE) 119次 ,血液灌流 (DHP) 6次 ,血浆吸附 (PP) 12次。观察发生并发症的情况及处理。结果 ALSS治疗中共发生并发症 4 4次 ,占 3 2 .12 % ,其中以血浆置换的并发症最多达 3 3 .61% ,并发症中以皮疹发生率最高 (16.79% ) ,其次为血压下降 (10 .2 2 % ) ,并发症中除 1例因术前并发多器官功能衰竭于术中休克死亡外 ,其余经对症处理后均好转。结论 ALSS治疗重症肝炎时 ,注意减少并发症的发生 ,是提高ALSS治疗成功的重要因素之一。
Objective To investigate the incidence and prevention of complications in the treatment of severe hepatitis with artificial liver support system (ALSS). Methods Nissan KM - 880 0 blood purifier was used to treat 37 cases of severe hepatitis with 119 times of plasma exchange (PE), 6 times of blood perfusion (DHP) and 12 times of plasma adsorption (PP). Observe the occurrence of complications and treatment. Results Complications of ALSS were treated 4 4 times (32.12%) in patients with ALSS, up to 33.61% of them were complicated by plasma exchange. The incidence of rash in complications was the highest (16.79%), followed by decreased blood pressure (10.22%). All the complications except one died of intraoperative shock due to preoperative multiple organ failure. All the patients were cured after symptomatic treatment. Conclusion ALSS treatment of severe hepatitis, pay attention to reduce the incidence of complications, is one of the important factors to improve the success of ALSS treatment.