Rakela J, Kurtz S B, McCarthy J T, Krom R A, Baldus W P, McGill D B, Perrault J, Milliner D S
Division of Gastroenterology and Internal Medicine, Mayo Clinic, Rochester, MN 55905.
Mayo Clin Proc. 1988 Feb;63(2):113-8. doi: 10.1016/s0025-6196(12)64943-x.
We conducted a pilot study to assess the feasibility and efficacy of postdilution hemofiltration (PDHF) in the management of acute hepatic failure. From January 1984 through May 1986, we encountered seven patients with acute hepatic failure and entered these consecutive patients in the study; three had non-A, non-B hepatitis and one each had type B hepatitis, fulminant Wilson's disease (hepatolenticular degeneration), acute allograft (liver) failure, and acute fatty liver of pregnancy. Two of these seven patients were unable to undergo PDHF because of a precarious hemodynamic status. Of the five patients treated with PDHF, four had amelioration of hepatic encephalopathy; in two of these patients, a close temporal relationship was noted between the improvement and the procedure. Four patients had appreciable thrombocytopenia related to PDHF and bleeding complications. Our preliminary results support a possible role for PDHF as a temporary artificial liver support system for patients with acute hepatic failure.
我们进行了一项初步研究，以评估后稀释血液滤过（PDHF）在急性肝衰竭治疗中的可行性和疗效。从1984年1月至1986年5月，我们遇到了7例急性肝衰竭患者，并将这些连续的患者纳入研究；3例为非甲非乙型肝炎，1例为B型肝炎、暴发性威尔逊病（肝豆状核变性）、急性同种异体（肝脏）移植失败和妊娠急性脂肪肝。这7例患者中有2例因血流动力学不稳定而无法进行PDHF。在接受PDHF治疗的5例患者中，4例肝性脑病得到改善；其中2例患者的改善与治疗过程之间存在密切的时间关系。4例患者出现与PDHF相关的明显血小板减少和出血并发症。我们的初步结果支持PDHF作为急性肝衰竭患者临时人工肝支持系统的可能作用。
