Clinical efficacy of modulation of intestinal microecology and plasmapheresis for preventing and treating multiple organ failure in patients with severe hepatitis / 临床肝胆病杂志

ABSTRACT

ObjectiveTo explore the methods for prevention and treatment of endotoxemia and multiple organ failure in patients with severe hepatitis. MethodsA total of 61 patients with severe hepatitis and toxic enteroparalysis were randomly assigned to three groups. The first group was treated with plasmapheresis, the second group with plasmapheresis and colon dialysis, and the third group with plasmapheresis, colon dialysis, and oral probiotics. Analyses were performed on the clinical symptoms and physical signs, hepatic function, endotoxin level, and clinical outcome in each group. Comparison of continuous data between groups was performed by analysis of variance, and further pairwise comparison by SNK test; comparison of categorical data between two groups was performed by chi-square test. ResultsThe liver function improved in all groups after treatment. The endotoxin level was significantly lower in the third group than in the other two groups (P＜005). The symptom improvement rates in the three groups were 35.3%, 64.7%, and 81.5%, respectively; the recurrence rates were 833%, 727%, and 364%, respectively; the clinical remission rates were 5.9%, 17.6%, and 48.1%, respectively, and the third group had a significantly higher rate than the first group (χ2=8.59, P＜0.05). ConclusionA combination of plasmapheresis, colon dialysis, and oral probiotics can effectively improve the prognosis of patients with severe hepatitis and toxic enteroparalysis, and can help prevent and treat multiple organ failure in such patients.