方定安 唐任光 周益強(qiáng)

[摘要] 目的 探討病毒滅活血漿與普通冰凍血漿在慢加急性肝衰竭患者治療中血漿置換的應(yīng)用效果。 方法 前瞻性選取68例2018年1月至2020年12月在百色市轄區(qū)右江民族醫(yī)學(xué)院附屬醫(yī)院和百色市人民醫(yī)院收治的慢加急性肝衰竭患者作為研究對象，按照隨機(jī)數(shù)字表法將所選患者分為對照組（n=34）與試驗(yàn)組（n=34）。對照組給予普通冰凍血漿進(jìn)行治療，試驗(yàn)組給予病毒滅活血漿進(jìn)行治療，兩組均持續(xù)治療1個(gè)月。比較兩組治療后的臨床療效、治療前后的凝血指標(biāo)、生物化學(xué)檢測指標(biāo)及治療期間的不良反應(yīng)發(fā)生率。 結(jié)果 治療后，試驗(yàn)組總有效率（79.41%）與對照組（70.59%）比較，差異無統(tǒng)計(jì)學(xué)意義（P>0.05）。治療前后，兩組血漿凝血酶原時(shí)間（PT）、活化部分凝血活酶時(shí)間（APTT）、纖維蛋白原（FIB）水平比較，差異均無統(tǒng)計(jì)學(xué)意義（P>0.05）。與治療前比較，治療后試驗(yàn)組血清C反應(yīng)蛋白（CRP）水平降低，且低于對照組（P<0.05）。與治療前比較，治療后，兩組血清直接膽紅素（DBIL）、總膽紅素（TBIL）水平均降低，但組間比較，差異均無統(tǒng)計(jì)學(xué)意義（P>0.05）。治療期間，試驗(yàn)組不良反應(yīng)發(fā)生率為8.82%，低于對照組的29.41%（P<0.05）。 結(jié)論 病毒滅活血漿與普通冰凍血漿用于慢加急性肝衰竭患者血漿置換中的應(yīng)用效果差別不顯著，但相比普通冰凍血漿，病毒滅活血漿的安全性更高。

[關(guān)鍵詞] 肝衰竭;慢加急性;病毒滅活血漿;普通冰凍血漿;血漿置換;效果

[中圖分類號] R575.3? ? ? ? ? [文獻(xiàn)標(biāo)識碼] A? ? ? ? ? [文章編號] 1673-9701（2021）24-0041-04

Application effect of virus-inactivated plasma and ordinary frozen plasma in plasma exchange in patients with chronic and acute liver failure

FANG Ding′an1? ?TANG Renguang2? ?ZHOU Yiqiang3

1.Department of Blood Supply， Baise Central Blood Station in Guangxi Zhuang Autonomous Region， Baise? ?533000， China; 2.Department of Blood Transfusion， Affiliated Hospital of Youjiang Medical University for Nationalities， Baise 533000， China; 3.Department of Blood Transfusion， Baise People′s Hospital in Guangxi Zhuang Autonomous Region， Baise? ?533000， China

[Abstract] Objective To explore the application effect of virus-inactivated plasma and ordinary frozen plasma in plasma exchange in patients with chronic and acute liver failure. Methods A total of 68 patients with chronic and acute liver failure admitted to the Affiliated Hospital of Youjiang Medical University for Nationalities and Baise People's Hospital from January 2018 to December 2020 were selected prospectively. They were divided into the control group（n=34） and the experimental group（n=34） using random number table method. The control group were treated with ordinary frozen plasma， and the experimental group were treated with virus-inactivated plasma. Both groups were treated for 1 month. The clinical efficacy， coagulation indexes， and biochemical indexes before and after treatment， and the incidence of adverse events during treatment were compared between the two groups. Results After treatment， the total effective rate of the experimental group （79.41%） was higher than that of the control group （70.59%）， without statistically significant difference（P>0.05）.There was no significant differences in plasma prothrombin time （PT）， activated partial thromboplastin time （APTT）， and fibrinogen （FIB） levels between the two groups before and after treatment（P>0.05）.The level of serum C-reactive protein （CRP） in the experimental group was decreased after treatment and was lower than that in the control group（P<0.05）.The levels of serum direct bilirubin （DBIL） and total bilirubin （TBIL） in both groups were decreased after treatment， and there were no statistically significant differences between the two groups（P>0.05）.The incidence of adverse events in the experimental group （8.82%） was lower than that in the control group（29.41%） during treatment（P<0.05）. Conclusion There is little difference in the application effect of virus-inactivated plasma and ordinary frozen plasma in plasma exchange in patients with chronic and acute liver failure. Virus-inactivated plasma is safer than ordinary frozen plasma.