Silk D B, Trewby P N, Chase R A, Mellon P J, Hanid M A, Davies M, Langley P G, Wheeler P G, Williams R
Lancet. 1977 Jul 2;2(8027):1-3. doi: 10.1016/s0140-6736(77)90001-0.
24 patients with fulminant hepatic failure who had deteriorated to grade-IV coma were treated by repeated periods of haemodialysis with a polyacrylonitrile membrane. 9 patients fully recovered consciousness, and 8 (33%) survived to leave hospitals. These results are to be compared with those of conservative management alone (15% survival in 53 cases) and those obtained initially with charcoal haemo-perfusion (38%). Of the 16 treatment failures, cerebral oedema was found at necropsy in 13 (18%). Whether this would have been less of problem if treatment had been started earlier in the course of the illness remains to be determined.
24例暴发性肝衰竭且已恶化为Ⅳ级昏迷的患者接受了使用聚丙烯腈膜的反复血液透析治疗。9例患者完全恢复意识，8例（33%）存活出院。这些结果将与单纯保守治疗的结果（53例中15%存活）以及最初使用活性炭血液灌流获得的结果（38%）进行比较。在16例治疗失败的患者中，尸检发现13例（18%）有脑水肿。如果在疾病过程中更早开始治疗，这是否会成为一个较小的问题仍有待确定。
