Effect of Artificial Liver Plasma Exchange Combined with CRRT in the Treatment of Hepatitis B-Related Chronic Acute Liver Failure Complicated with Acute Renal Failure and Its Impact on Prognosis
Effect of Artificial Liver Plasma Exchange Combined with CRRT in the Treatment of Hepatitis B-Related Chronic Acute Liver Failure Complicated with Acute Renal Failure and Its Impact on Prognosis
Objective To explore the effect of artificial liver plasma exchange combined with continuous renal re-placement therapy(CRRT)in the treatment of patients with hepatitis B-related acute-on-chronic liver failure(ACLF)compli-cated with acute renal failure(ARF)and its impact on the prognosis and outcomes.Methods Clinical data of 62 patients with HBV-related ACLF complicated with ARF treated from May 2019 to October 2020 were retrospectively analyzed,and were divided into observation group(n =31)and control group(n =31)according to treatment methods.The observation group re-ceived artificial liver plasma exchange combined with CRRT,and the control group received artificial liver plasma exchange.Liver and kidney function,inflammatory factors,blood routine indexes and electrolyte levels were compared before and at 4 weeks after treatment.The 90-day survival of the two groups after treatment was compared.Results At 4 weeks after treat-ment,alanine aminotransferase,total bilirubin,urea,tumor necrosis factor-α,interferon-γ and interleukin-12 in the two groups were lower than those before treatment,and lower in the observation group than in the control group(P＜0.05).At 4 weeks after treatment,hemoglobin and platelet count levels in the two groups were decreased compared with those before treat-ment(P＜0.05).At 4 weeks after treatment,prothrombin activity,glomerular filtration rate and endogenous creatinine clear-ance in the two groups were significantly higher,which were higher in the observation group than in the control group(P＜0.05).At4 weeks after treatment,there was no significant difference in blood potassium,blood sodium and blood chlorine levels between the two groups before and after treatment(P＞0.05).The survival time of observation group was longer than that of control group(P＜0.05).Conclusion Artificial liver plasma exchange combined with CRRT is effective in the treat-ment of hepatitis B-related ACLF combined with ARF,which helps to improve liver and kidney function,has little impact on the body's electrolyte level,and can effectively inhibit inflammation and prolong the survival of patients.
维普
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