Analysis Of Efficacy Of Plasma Exchange In Treatment Of Liver Failure

Background and objectiveLiver failure means that the liver is severely damaged and its physiological functions(biotransformation,synthesis,excretion,and detoxification)do not proceed normally,resulting in jaundice,blood clotting disorders,ascites,and hepatic encephalopathy and so on.Liver failure develops rapidly and has a high mortality rate.Internal medicine comprehensive treatment,artificial liver and liver transplantation are clinical treatments which currently used more.The comprehensive treatment of internal medicine lacks specific drugs,mainly symptomatic treatment.The only effective method is liver transplantation,however,the lack of source of donor organs,the difficulty of operation and the high cost,these problems limit the wide application of this treatment.The artificial liver support system is generated under the above background and plays an important role in the treatment of liver failure.Artificial liver has many methods,plasma exchange is widely used in our country,but the efficacy of treatment of liver failure is mixed.This study used a prospective study to analyze the effect of plasma exchange on liver failure,and to explore factors related to prognosis of patients with liver failure,so as to provide theoretical basis for the clinical application of plasma exchange.MethodsChoose 105 liver failure from January 2015 to December 2016 in our hospital,then randomly divided into two groups,52 in the treatment group and 53 in the control group.The treatment group was given medical treatment and plasma exchange was added.The control group was only medical treatment.The efficacy evaluation indicators include clinical symptoms and biochemical tests and analyze factors related to prognosis.Results1.Comparison of clinical symptomsAfter treatment the clinical symptoms(nausea,vomiting,bloating,etc.)were improved in both groups,and the treatment group improved more significantly.2.The main laboratory indicatorsIn the treatment group,after plasma exchange treatment,the levels of hemoglobin,alanine aminotransferase,aspartate aminotransferase,serum total bilirubin,and international normalized ratio were reduced(p<0.05);serum sodium,prothrombin time activity,and albumin were elevated(p<0.05).3.Effect of contrastAfter 12 weeks,the treatment effect was evaluated.The effective rate in the treatment group was 57.7%(30/52),the effective rate in the control group was 32.0%(17/53),the difference was statistically significant(p<0.05).Comparing the treatment efficiency of the two groups of patients with different stages,the effective rate of the early and middle stages of acute and chronic liver failure in the treatment group was higher than that in the control group(p<0.05).There was no difference between the two groups in acute,acute-chronic liver failure later term and chronic liver failure.(p>0.05).4.Prognostic analysisWBC is negatively correlated with the prognosis of patients with liver failure,and ALB is positively correlated with the prognosis of patients with liver failure.Conclusion1 Plasma exchange can improve hepatic function and coagulation function indexes such as ALT?AST?TBIL?PTA?INR in patients with liver failure.2 Early intervention of plasma exchange can improve the prognosis of early and medium-term acute-on-chronic liver failure.3 The lever of white blood cell and albumin were the predictors of prognosis in patients with liver failure.