Comparison Of The Efficacy Of Low-Dose Plasma Exchange Combined With Double Plasma Molecular Adsorption System And Plasma Exchange In The Treatment Of Severe Hepatitis

Objective :To study the efficacy of low-dose plasma exchange combined with double plasma molecular adsorption system and plasma exchange in the treatment of severe hepatitis.Methods : A total of 63 patients with severe hepatitis caused by various causes from January 1,2019 to December 31,2020 in the Department of Infectious Diseases,Affiliated Hospital of Youjiang Medical College for Nationalities were selected and divided into DPMAS + LPE group and simple PE group.The clinical signs,laboratory tests(liver function,coagulation function)and effective rate of the two groups before and after artificial liver treatment were compared.Results : The effective rate of DPMAS + LPE group was significantly higher than that of PE group(P = 0.046).The effective rate of DPMAS + LPE group was 83.8 %,and the effective rate of PE group was 61.5 %.After treatment in the simple PE group : transaminase and bilirubin(ALT,AST,TBIL,DBIL,UDBIL)decreased significantly,and ALB improved significantly(P < 0.05);PT,INR and TT were significantly improved in coagulation function,and PTA was significantly higher than before(P < 0.05).APTT and Fbg had no significant effect on the efficacy.After DPMAS + LPE treatment : transaminase and bilirubin(ALT,AST,TBIL,DBIL,UDBIL)decreased significantly,ALB improved significantly(P<0.05);PT,INR and TT were significantly improved in coagulation function,and PTA was significantly higher than before(P < 0.05).APTT and Fbg had no significant effect on the efficacy.There was no significant difference in the data between the two groups before treatment.There was no significant difference in coagulation function between the two groups after treatment.The difference in liver function between the two groups was statistically significant.The efficacy of DPMAS + LPE group was better than that of PE group.Conclusion : Both PE group and DPMAS + LPE group can significantly improve the liver function and coagulation function of patients with severe hepatitis.The two groups are more effective than the DPMAS + LPE group,and the amount of plasma used is significantly less.