The Clinical Research About Prognosis Of Liver Failure

Background:Liver failure is caused by many factors of liver cells large, sub-massive necrosis or severe damage, leading to its synthesis, detoxification, excretion and biotransformation of serious disorders such as liver function or decompensation, appear to jaundice, coagulopathy, hepatic encephalopathy and ascites as the main manifestations of a clinically significant syndrome. The disease develops rapidly, the disease risks of complications and high mortality, but the potential can be reversed. Therefore accurately determine the prognosis of liver failure in the implementation of effective treatment is essential. In the current, medical treatment of liver failure lack of effects of drugs and instruments. In principle, we emphasize that early diagnosis and early treatment for different causes of comprehensive treatment to take corresponding measures, and to prevent and treat complications. For glucocorticoids in the treatment of liver failure is currently surviving in the different views. Most scholars believe that early stage of liver failure, if the rapid progression of the disease without serious infection, bleeding and other complications, may be appropriate to use. Artificial liver support system is an effective treatment of liver failure in one of the methods, its application in liver failure early and mid-term is appropriate; advanced liver failure patients can be treated, but more common complications.Objective: To investigate the prognosis of liver failure were independent risk factors; evaluation of hormone therapy and the artificial liver treatment of liver failure on the prognosis.Methods: Retrospective analysis of 200 cases of liver failure cases with complete data, collected clinical data, using statistical methods to analyze the different causes and different types of the prognosis of patients with liver failure; screened for HBV-related acute on chronic (sub-acute) prognosis of liver failure independent risk factors affecting; contrast Child-Turcotte-Pugh scoring system, MELD scoring system, and MELD-Na score system for predicting the prognostic value of liver failure; evaluation of hormone therapy and the artificial liver treatment of liver failure on the prognosis.Results:1. HBV induced liver failure group survival rate was 43.17%, other causes of liver failure, survival rate was 70.59%, there is significant difference in survival between the two groups (P<0.05); acute on chronic (sub-acute) liver failure survival rate was 54.71%, other types of liver failure, survival rate was 36.59%, there is significant difference in survival between the two groups (P<0.05).2. Logistic regression selected by the impact of HBV-related acute on chronic (sub-acute) liver failure were independent risk factors: age≥50y, separation of bile enzymes, liver cirrhosis, complications (especially hepatic encephalopathy, infection, primary peritonitis), CTP score, MELD-Na score, TBIL, PTA, Na+ and TC.3. Hormone therapy group compared with non-hormone therapy in HBV-related acute on chronic (sub-acute) of early liver failure, two groups were significantly different survival rate, survival rate of the former than the latter (P<0.05); in HBV-related slow plus acute (sub-acute) liver failure mid no significant difference in survival the two groups (P> 0.05); two of liver failure in the course of the disease early and mid-term were statistically significant (P>0.05), the former`s course is shorter than the latter. Artificial liver in treatment group compared with non-artificial liver treatment in HBV-related acute on chronic (sub-acute) liver failure early and mid-term, the two groups were significantly different survival (P<0.05); in the late liver failure, two groups of survival There was no significant difference (P>0.05).Conclusion: Age≥50y, separation of bile enzymes, liver cirrhosis, complications (especially hepatic encephalopathy, infection, primary peritonitis), CTP score, MELD-Na score, TBIL, PTA, Na+ and TC is the impact of HBV slow plus acute (sub-acute) prognosis of patients with liver failure were independent risk factors. Hormone therapy may improve early HBV-related acute on chronic (sub-acute) the survival rate of patients with liver failure and shorten the course of the disease; artificial liver treatment can improve the early and mid-term HBV-related acute on chronic (sub-acute) the survival rate of patients with liver failure.