Shen Yan, Shi Liping, Deng Luxi, Zhao Xiaoling
Department of Infectious Diseases, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu, China.
Evid Based Complement Alternat Med. 2023 Apr 8;2023:8201776. doi: 10.1155/2023/8201776. eCollection 2023.
To analyse the influencing factors of tube blockage during the treatment of artificial liver in patients with drug-induced liver failure and explore effective patient protection strategies.
In this study, 49 patients with pharmacological (antituberculosis drugs, antibiotics, proprietary Chinese medicine, gastric drugs, and antihyperthyroid drugs) liver failure admitted to our hospital from June 2015 to December 2021 were selected for prospective analysis. Clinical indicators and general data of all patients were collected and collated, risk factors leading to the obstruction of artificial liver treatment were analysed, and corresponding protective measures were proposed.
The incidence of tube blockage was 5.32% (10 times) in 49 patients with pharmacological liver failure treated 188 times with artificial liver therapy. The incidence of tube blockage was significantly higher in patients in the PDF mode than in those in the PP and PE modes ( < 0.05), and there were differences in the location of blocked tubes between the treatment modes. Blocked tubes occurred more often in the venous cauldron of the circuit in the PDF mode and in the plasma separator of the circuit in the PP mode. The incidence of tube blockage was significantly lower in patients with no more than 3 treatments than in those with 3 to 5 treatments and those with more than 5 treatments ( < 0.05). The incidence of catheter blockage was higher in patients with PTA values ≤20% than in those with PTA values between 20% and 30%, and higher than in those with PTA values above 30% ( < 0.05).
The risk factors of tube plugging in patients with liver failure treated with artificial liver include different treatment modes, different treatment times, and different PTA values. The PDF mode has a higher rate of tube plugging than PE or PP treatment modes. The more the number of treatment times and the lower the PTA value of patients, the more tube plugging is likely to occur.
分析药物性肝衰竭患者人工肝治疗期间管路堵塞的影响因素，探索有效的患者保护策略。
本研究选取2015年6月至2021年12月我院收治的49例药物性（抗结核药、抗生素、中成药、胃药及抗甲状腺药）肝衰竭患者进行前瞻性分析。收集并整理所有患者的临床指标及一般资料，分析导致人工肝治疗管路堵塞的危险因素，并提出相应的保护措施。
49例药物性肝衰竭患者接受188次人工肝治疗，管路堵塞发生率为5.32%（10次）。PDF模式患者的管路堵塞发生率显著高于PP和PE模式患者（<0.05），且不同治疗模式下堵塞管路的部位存在差异。PDF模式下堵塞管路多发生在体外循环静脉壶，PP模式下多发生在体外循环血浆分离器。治疗次数不超过3次的患者管路堵塞发生率显著低于治疗3至5次及超过5次的患者（<0.05）。凝血酶原活动度（PTA）值≤20%的患者导管堵塞发生率高于PTA值在20%至30%之间的患者，且高于PTA值>30%的患者（<0.05）。
人工肝治疗肝衰竭患者管路堵塞的危险因素包括不同的治疗模式、不同的治疗次数及不同的PTA值。PDF模式的管路堵塞发生率高于PE或PP治疗模式。患者治疗次数越多、PTA值越低，越容易发生管路堵塞。
