The Clinical Observation Of Plasma Exchange In The Treatment Of Patients With Liver Failure

Objective To observe the clinical efficacy of plasma exchange in the treatment ofliver failure.Methods Retrospective analysis of clinical data in patients with liver failure,33patients in PE group were treated with plasma exchange on the basis of conventionaltherapy,30patients in control group were treated with conventional therapy.Theclinical symptoms、complications、the changes in biochemical markers of liverfunction were observed after2weeks treatment,follow-up the outcome within threemonths after treatment and analyze the factors influencing efficacy.Results①After treatment,patients with anorexia、fatigue、bloating and other symptomsimproved significantly.The ALT and TBiL after treatment were respectively lowerthan those before treatment （390.48±536.52U/L VS81.03±47.58U/L；479.27±130.01umol/L VS244.64±151.05umol/L）,while ALB、CHO and PTAwere higher than those before treatment（33.06±5.42g/L VS35.24±3.68g/L；2.50±1.24mmol/L VS3.59±0.86mmol/L；34.16±5.33%VS73.98±27.23%）,andthe differences were statistically significant(P＜0.05).No significant difference inALT、TBiL、ALB、CHO、PTA levels after treatment than before in the controlgroup（P＞0.05）.②The improvement rate was significantly higher in patients in PE group than incontrol group（χ2=8.276，P＜0.05）,while the fatality rate was lower in patients inPE group than in control group（χ2=13.258，P＜0.05）；③PE treatment effect related with age40or more、complications、TBiL level andbilirubin enzyme separation.TBiL level and bilirubin enzyme separation is an independent risk factor affecting the efficacy of PE（P＜0.05，OR were1.01、8.75）.④8cases of adverse reactions happened in PE,and it disappeared after symptomatictreatment.Conclusion Plasma exchange is an effective and safe treatment for liver failure,andhave promotional value in clinical.TBiL level and bilirubin enzyme separation is anindependent risk factor affecting the efficacy of PE.