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用治疗性血交换和连续脏替代疗法治疗儿科肝衰竭的管理:一项回顾性观察性研究

Mustafa Colak¹, Ilhan Ocak

¹Department of Liver Transplantation Intensive Care Unit, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey.

|May 10, 2024

概括

治疗性血交换 (TPE) 和连续毒性血液过 (CVVHDF) 有效地治疗儿科肝衰竭,改善患者的治疗结果,并作为移植的桥梁. 这些疗法在治疗儿童急性和慢性肝衰竭方面显示出显著的临床益处.

科学领域:

儿科重症监护医药儿科重症监护医药
肝病学肝病学是一种肝病学.
脏替代疗法是指脏替代疗法.

背景情况:

儿童的肝衰竭是一种需要立即干预的危急状况.
治疗性血交换 (TPE) 和连续毒性血液过 (CVVHDF) 是肝衰竭的新兴治疗方法.
在儿科肝衰竭中TPE和CVVHDF的联合疗效是目前正在积极研究的领域.

研究的目的:

评估单独使用TPE与与CVVHDF结合使用TPE在治疗儿科肝功能衰竭中的疗效.
评估这些疗法作为通往肝移植的桥梁的作用.

主要方法:

对24名患有急性或急性至慢性肝衰竭的儿科患者 (1个月至18岁) 的回顾性研究.
患者接受单独的TPE或与CVVHDF结合的TPE.
评估了INR,氨酸转移酶和酸氨酸转移酶水平的变化.

主要成果:

单独使用TPE和使用CVVHDF的TPE都显著降低了INR,ALT和AST水平 (P < .05).
中位数INR从3.1降至1.26 (仅TPE) 和从3.9降至1.26 (TPE+CVVHDF).
总的来说,有14名患者在没有移植的情况下存活下来,4人接受了移植,这表明58%的无移植生存率.

结论:

独立的TPE和与CVVHDF结合的TPE是小儿肝衰竭的有效治疗方法.
这些疗法作为肝移植的宝贵桥梁,改善了临床结果.
需要进一步的多中心研究来验证这些发现在更广泛的人群中.

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