中国实用儿科杂志2011，Vol.26Issue(4)：272-274,3.
连续性静-静脉血液净化辅助治疗儿童急性肝功能衰竭5例临床分析
Continuous veno-venous hemodialysis/filtration in the treatment of acute liver failure in children:clinical analysis of 5 cases
戎群芳 1张育才 1朱艳 1崔云 1奚佳铭1
作者信息
- 1. 上海交通大学附属儿童医院重症医学科,上海,200040
- 折叠
摘要
Abstract
Objective To investigate the efficacy of continuous veno-venous hemodialysis/filtration (CVVHDF) in children with acute liver failure. Methods Five cases of acute liver failure in children were treated in Shanghai Jiao Tong University affiliated Children' s Hospital from May 2009 to May 2010. Two cases were male and 3 cases female, aged from 10 months to 5 years old. The duration of disease on admission was 3 d to 14 d. Three cases of acute liver failure were caused by medicine(paracetamol), 1 case was caused by severe sepsis, and 1 case was caused by pylephlebitis. The hepatic encephalopathy class of the patients were: 1 case (grade 2), two cases (grade 3), two cases (grade 4). Besides protecting liver function drugs, we used CVVHDF to treat the patients and closely monitored the vital sign, liver function and complications. Results The time of CVVHDF initiated was 2 h to 24 h after admission. The total duration of CVVHDF was 24 h to 144 h. Three cases recovered, 1 case withdrew and 1 case died. Twelve hours after CVVHDF, ALT decreased from (3888.76 ± 2373.60) U/L before CVVHDF to (3284.80 ± 1974.80) U/L and continued to decrease (F =3.58, P ＜ 0.05). Blood ammonia decreased from (209.00 ± 53.61 ) μmol/L to ( 158.80 ± 60.93) μmol/L (F = 3.75, P ＜0.05), and TBIL improved after 12 h ～48 h, but there was no statistical difference compared with those at the beginning of CVVHDF (F = 0.23, P ＞ 0.05 ).The blood pressure was stable during the course of treatment. Conclusion CVVHDF treatment for acute liver failure can improve clinical symptom and abnormal biochemical indicator; it may be used as an effective method for treating acute liver failure in pediatric patients.关键词
急性肝功能衰竭/连续性静-静脉血液透析/滤过/儿童分类
医药卫生引用本文复制引用
戎群芳,张育才,朱艳,崔云,奚佳铭..连续性静-静脉血液净化辅助治疗儿童急性肝功能衰竭5例临床分析[J].中国实用儿科杂志,2011,26(4):272-274,3.
