Objective To evaluate the application effects of plasma exchange (PE), plasma exchange (PE) + continuous renal replacement therapy (CRRT), and dual plasma molecular adsorption system (DPMAS) + half volume plasma exchange (HPE) mode in the treatment of patients with liver failure.
Methods The clinical data of 141 patients with liver failure treated with NBAL were analyzed retrospectively. According to the different treatment modes of artificial liver, the patients were divided into the PE model group (n = 41), PE + CRRT model group (n = 48) and DPMAS + HPE model group (n = 52). The laboratory index, Meld score, Child-pugh score and survival of three groups were observed before and after artificial liver treatment.
Results Compared with those before treatment, the glutamic pyruvic transaminase, total bilirubin, prothrombin time, Meld score and Child-pugh score decreased significantly, and the prothrombin activity increased significantly in three groups after treatment (P ＜ 0.05). In PE + CRRT model group, the serum potassium concentration increased (P ＜ 0.05), and the blood ammonia and C-reactive protein decreased after treatment (P ＜ 0.05). The C-reactive protein, hemoglobin and platelet count decreased after treatment in DPMAS + HPE mode group (P ＜ 0.05). There was no statistical significance in the 1-, 3-, 6-, 9- and 12-month survival rates among three groups (P ＜ 0.05).
Conclusions The three artificial liver treatment modes can effectively improve the liver function, blood coagulation function, Meld score and Child-pugh score of patients with liver failure. The PE + CRRT mode has more advantages in adjusting electrolyte disorder and removing blood ammonia. DPMAS + HPE mode has a certain effect on hemoglobin and platelets. Clinical treatment should be based on the patient's condition to improve the therapeutic effect. Clinical practice should combine the patient's condition to adopt an appropriate treatment model for improving the therapeutic effect.
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