Patients With Severe Hepatitis, Liver Failure Treated Anticoagulants On Coagulation Impact And Fat Emulsion In Its Clinical Applications

Artificial liver support system (ALSS) is an assistant device in the treatment of liver failure. It can substitute the functions of the liver by extracorporeal support. Effectiveness and safety of anticoagulation is important during the treatment of artificial liver. Now there is no acceptable anticoagulant and anticoagulation methods during the treatment of ALSS, and always consults the anticoagulation methods of hemodialysis with an anticoagulant of standard heparin (SH). Low molecular weight heparin (LMWH) has been used since 1970, and has virtues of convenient use, low complication and little infection for metabolizm. The patients for the treatment of ALSS have lower coagulation function because of the impediment of liver function. It has been focus on whether using in the patients. There hasn't been issue of use of anticoagulant during ALSS inside and outside the country. Therefore, we make research on the patients about use and effect of different anticoagulant during ALSS.According to different means of anticoagulant, twenty severe hepatitis patients were divided into 2 groups randomly. There were as follows: heparin group; LMWH group, and gave ALSS in 2 groups. This study was designed to: (1) investigate the influence on patients, coagulation of different anticoagulant during the treatment of ALSS, and (2) using methods and causing complications of different anticoagulant.The main results were as follow:1. There were no significant differences in hemoglobin levels before and after treatment in two groups, and platelet levels were significantly lower after treatment in SH and LMWH groups.2. Prothrombin time (PT) and activated partial thromboplastin time (APTT) levels increased significantly after treatment in heparin group, and they were significantly lower after treatment in LMWH group.3. There were increased with fibrinogen and thrombin time and factor Ⅷ levels in heparin and LMWH groups, but alpha-granule membrane protein (GMP-140) levels increased in heparin group and decreased in LMWH group. 4. There were more changes with platelets in heparin than LMWH after threatment of ALSS, for example, could have abnormal and more activated platelets.5. It could cause many complications, for example, blood pressure lowing, in heparin group.The results of this experimental study heparin show that:1. ALSS is relatively safe, and there is no influence on red cell. But each anticoagulant can make platelets low.2. More bleeding complications can be caused in heparin group than in LMWH group because of prothrombin time and activated partial thromboplastin time becoming high in heparin group.3. Heparin can cause more activation of platelets than LMWH, and can aggravate the damage of live function.4. There are fewer complication in LMWH, can use conveniently and routinely.