Clinical research of plasma diafiltration in the treatment of severe liver failure / 中国医师杂志

ABSTRACT

Objective:To study the clinical effect of plasma diafiltration in severe liver failure.Methods:The clinical data of 64 patients with severe liver failure treated in Changsha Central Hospital Affiliated to Nanhua University from January 2019 to January 2021 were retrospectively analyzed. The control group ( n=32) was treated with plasma exchange; The observation group ( n=32) was treated with plasma dialysis and filtration, and the clinical therapeutic effects of the two groups were compared. Results:The total effective rate of observation group was 96.88%(31/32), which was significantly higher than that of control group (78.13%, 25/32) ( P<0.05). After treatment, there was no significant difference in total bilirubin and direct bilirubin between the observation group and the control group (all P>0.05), but the alanine aminotransferase [(94.02±31.31)U/L] in the observation group was significantly lower than that in the control group [(160.79±53.55)U/L] ( P<0.05). After treatment, the serum creatinine [(87.80±10.7) μmol /L] and ammonia [(56.80±4.73)μmol/L] in the observation group were significantly lower than those in the control group [(101.57±25.34)μmol/L, (101.87±10.34)μmol/L, all P<0.05]. The plasma consumption of observation group [(1 582.25±125.15)ml] was significantly less than that of control group [(2 262.50±208.29)ml] ( P<0.05). The incidence of adverse reactions in the observation group was 3.13%(1/32), which was significantly lower than that in the control group [25.00%(8/32)], with statistically significant difference ( P<0.05). Conclusions:Compared with plasma exchange, plasma dialysis and filtration in the treatment of severe liver failure can effectively improve the liver function of patients, with better clearance of small molecule toxins. Moreover, plasma dialysis and filtration has less amount of plasma use , higher safety, and better clinical application value.