Clinical Comparative Study Of Plasma Adsorption Combined With Semi-volume Plasma Exchange In The Treatment Of Liver Failure

Objective: Through the analysis of the curative effect of plasma adsorption combined with half-volume plasmapheresis in the treatment of liver failure,discussed the application value and the possibility of its clinical application and popularization.Methods: 1.According to the APASL guidelines of 2015 for the diagnosis and treatment of liver failure,excluded the patients those who with late pregnancy,severe infection,sepsis,severe cardiopulmonary renal insufficiency,active bleeding and malignant tumor,84 artificial liver therapy patients were divided into experimental group(n=30)and control group(n=54),all patients were treated on the basis of conventional symptomatic support in the same internal medicine,the experimental group was treated with plasma adsorption combined with half-volume plasma exchange,and the control group was treated with plasmapheresis;2.Femoral vein catheterization was performed in allpatients,followed the 2007 artificial liver support system operating guidelines;3.Collected patients peripheral venous blood before artificial liver treatment and after treatment,blood of 72 h,testing the detection of total bilirubin(TBIL),direct bilirubin(DBIL),alanine aminotransferase(ALT),aspertate aminotransferase(AST),albumin(ALB),white blood cells(WBC),international standardization ratio(INR),interleukin 1 beta(IL-1β),interleukin 6(IL-6),tumor necrosis factor alpha(TNF-α)values percentage.Results:1.After the artificial liver treatment in two group experience,TBIL value and DBIL value decreased by a statistically significant percentage(P<0.05),the experimental group have even greater percentage drop,curative effect is better;There was no statistical significance in the percentage decrease of ALT,AST and INR’s value,also with the percentage increase of ALB(P>0.05),they are equally effective;but there was a statistically significant difference in the percentage of WBC increase between the two groups after artificial liver treatment(P<0.05),and the increase in the experimental group was more obvious.2.In the experimental group and the control group,before and after artificial liver treatment,the percentages of IL-1β,IL-6 and TNF-αdecreased were no statistically significance(P>0.05),they are equally effective;There were significant differences in the changes of IL-6 valuebetween the two groups after artificial liver treatment and 72 hours after artificial liver treatment(P>0.05);In the IL-1β and TNF-α between after artificial liver treatment and 72 h after artificial liver treatment,there was no significant difference(P>0.05).3.After treatment,liver function of the experimental group improved significantly,and TBIL decreased the most significantly,especially after artificial liver treatment and 72 h after artificial liver treatment,followed by DBIL,ALT and AST,respectively,and ALT,AST,TBIL and DBIL all decreased significantly at 4h after adsorption treatment,indicating that the experimental group could significantly reduce bilirubin and improve liver function.Significance: The new combined artificial liver plasma adsorption combined with half-volume plasmapheresis is effective in the treatment of liver failure.It is better than plasma exchange in reducing TBIL and DBIL,and the treatment efficacy of ALT,AST,ALB,INR,TI-1β,TNF-αis nearly the same in the two groups.