摘要
目的以人体新鲜冰冻血浆作透析液行血液透析(HD-PBD)后继续进行高容量血液滤过(HV-HF),观察其对高胆红素血症的治疗效果。方法7例高胆红素血症患者行HD-PBD治疗6h后,应用同一滤器继续行HVHF治疗24h。另选取6例行MARS治疗6h的高胆红素血症患者作为对照。各组患者治疗前后测定血清胆红素水平,并监测动脉血气分析和电解质浓度的变化。结果HD-PBD对胆红素的清除较HVHF明显(P<0.05),HVHF在纠正电解质和酸碱失衡方面比HD-PBD更显著(P<0.05)。停止HD-PBD后继续行HVHF治疗24h,胆红素仍有所下降(P<0.05);停止MARS治疗后的1～2天内胆红素显著升高(P<0.05)。结论HD-PBD联合HVHF治疗高胆红素血症患者,结合了二者在清除肝源性毒素和调节电解质酸碱平衡紊乱方面的优势,并且安全、简便、易行和成本低廉,值得推广应用。
Objective We proposed a new blood purification modalityhemodialysis with plasma-based dialysate(HD-PBD) plus high volume hemofiltration(HVHF) for patients with hyperbilirubinemia,and evaluated the effect of this treatment on removal of serum bilirubin. Methods Seven patients with hyperbilirubinemia were included in this study.After HD-PBD for 6 hours,then treated with HVHF for 24 hours with the same filter. Six patients treated with molecular adsorbent recirculating system(MARS) were as controls. Serum total bilirubin(TB), direct bilirubin(DB) and indirect bilirubin(IB) were detected before and after treatment in all patients. Arterial blood gas analysis and the concentration of electrolytes in all patients were monitored before and after treatment.Results HD-PBD for 6 hours is more effective in the removal of serum bilirubin than HVHF for 24 hours(P<0.05). There were no significant diffevence of arterial blood HCO-_3, PCO_2, PO_2 and electrolyte before and after HD-PBD(P>0.05), and aforementioned target is significanly different before and after HVHF (P<0.05). The average level of serum bilirubin was significantly increased in 1 to 2 days after MARS, but there was a significant decrease after HVHF for 24hours following HD-PBD(P<0.05). Conclusion HD-PBD plus HVHF,a newly proposed modality for patients with hyperbilirubinemia, Which combines the predominance in removal of serum bilirubin and excellent correction of electrolyte and acid-base disturbance, is a low-cost,safe,simple and convenient treatment, and deserve to be generalized in clinical application.
出处
《中国血液净化》
2005年第6期306-309,共4页
Chinese Journal of Blood Purification
基金
西京医院医疗新技术
新业务项目(XJGX04022M17)
