Comparison and Safety Analysis of Anticoagulant Effect between Ordinary Heparin and Nafamostat Anticoagulant Regimen in Artificial Liver Treatment of Liver Failure
Objective To explore the clinical efficacy and safety of nafamostat anticoagulant regimen in artificial liver treatment for liver failure,and to compare it with ordinary heparin anticoagulant regimen,to provide a theoretical basis for improving the anticoagulant effect of artificial liver therapy.Methods A total of 80 patients with liver failure were admitted to Qingdao Sixth People's Hospital from January 2022 to December 2023 and were treated with artificial liver therapy,among which,40 patients were selected as observation groups and were treated with nafamostat anticoagulant regimen,and 40 patients as the control group were treated with an ordinary heparin anticoagulant regimen.The anticoagulant effect(coagulation grade),changes in coagulation function[in vivo and in vitro activated thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT),platelet(PLT),international normalized ratio of coagulation(INR)],changes in liver function indexes[total bilirubin(TBIL),alanine aminotransferase(ALT),albumin(ALB)blood routine,and other biochemical indexes]were compared between the two groups and the occurrence of adverse reactions,adverse reactions mainly statistical bleeding,chills,urticaria,fever and so on.Results In terms of comparing anticoagulant effects,there was no statistically significant difference in the overall proportion of coagulation grades between the two groups of patients(P>0.05).There were no statistically significant difference in PT between the two groups of patients before and after treatment(P>0.05).After treatment,the PLT of both groups of patients decreased compared to before treatment(P all<0.05),and the PLT level in the observation group was higher than that in the control group(P<0.05).After treatment,the INR of both groups of patients decreased compared to before treatment(P all<0.05),and the in vivo APTT of the observation group was not significantly prolonged.And the in vitro APTT was significantly prolonged(P<0.05),while the in vivo and in vitro APTT of the control group patients were significantly prolonged(P all<0.05).There were no significant difference in liver function indicators between the two groups of patients before treatment(P>0.05).After treatment,the TBIL level in the observation group was significantly lower than that in the control group(P<0.05),while there was no statistically significant difference in ALB and ALT levels between the two groups after treatment(P<0.05).There were no significant difference in the incidence of adverse reactions between the two groups of patients(P>0.05).Conclusion Compared with ordinary heparin,nafamostat has a good anticoagulant effect and safety as an anticoagulant regimen for artificial liver treatment of liver failure.
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