赵丽娟, 陈小兰, 柏明, 于艳, 李洋平, 马峰, 许国双, 孙世仁. 胆红素吸附治疗心脏术后高胆红素血症的临床效果[J]. 心脏杂志, 2019, 31(5): 526-528, 533. DOI: 10.12125/j.chj.201905070
    引用本文: 赵丽娟, 陈小兰, 柏明, 于艳, 李洋平, 马峰, 许国双, 孙世仁. 胆红素吸附治疗心脏术后高胆红素血症的临床效果[J]. 心脏杂志, 2019, 31(5): 526-528, 533. DOI: 10.12125/j.chj.201905070
    Li-juan ZHAO, Xiao-lan CHEN, Ming BAI, Yan YU, Yang-ping LI, Feng MA, Guo-shuang XU, Shi-ren SUN. Clinical study of bilirubin adsorption in the treatment of hyperbilirubinemia after cardiac surgery[J]. Chinese Heart Journal, 2019, 31(5): 526-528, 533. DOI: 10.12125/j.chj.201905070
    Citation: Li-juan ZHAO, Xiao-lan CHEN, Ming BAI, Yan YU, Yang-ping LI, Feng MA, Guo-shuang XU, Shi-ren SUN. Clinical study of bilirubin adsorption in the treatment of hyperbilirubinemia after cardiac surgery[J]. Chinese Heart Journal, 2019, 31(5): 526-528, 533. DOI: 10.12125/j.chj.201905070

    胆红素吸附治疗心脏术后高胆红素血症的临床效果

    Clinical study of bilirubin adsorption in the treatment of hyperbilirubinemia after cardiac surgery

    • 摘要:
        目的  探讨胆红素吸附治疗心脏术后高胆红素血症患者的有效性和安全性。
        方法  回顾性的分析我院2017年1月~2018年12月应用胆红素吸附治疗的11例心脏术后急性肝功能不全患者的临床数据。记录患者基础疾病、心脏手术名称、术后胆红素升高时间及治疗前后肝功能、胆红素、凝血功能等指标变化。
        结果  患者11(男7,女4)例,年龄(45±13)岁,体外循环时间(226±104)min。治疗前血清总胆红素(409±137)μmol/L,直接胆红素(321±100)μmol/L,治疗后血清总胆红素(298±107)μmol/L,直接胆红素(166±111)μmol/L,治疗前后差异具有统计学意义(分别P<0.05,P<0.01)。转氨酶、血清总蛋白、白蛋白、国际标准化比值(INR)、血小板计数、白细胞计数、血红蛋白、尿素氮、肌酐在治疗前后差异无统计学意义。11例患者胆红素吸附共治疗22次,8例患者治疗1次,其余3例患者分别治疗2次、5次、7次。血清总胆红素下降率2.8%~47.6%。4例存活,7例死亡,生存率36%。治疗过程中未发现治疗相关副作用。
        结论  胆红素吸附治疗心脏术后高胆红素血症的是一种安全较为有效的降低胆红素及肝脏支持系统技术。

       

      Abstract:
        AIM  To evaluate the safety and efficacy of bilirubin adsorption in the treatment of hyperbilirubinemia after cardiac surgery.
        METHODS  Eleven patients with hyperbilirubinemia and acute liver failure after cardiac surgery whose were treated with bilirubin adsorption between Jan. 2017 to Dec. 2018 were retrospectively analyzed. Basic diseases, names of heart operation, cardiopulmonary bypass times, and the changes of liver function, bilirubin and coagulation index before and after treatment were recorded.
        RESULTS  Among the 11 patients, 7 were males and 4 were females, with an average age of (45 ± 13) years and a mean cardiopulmonary bypass time of (226 ± 104) min. After bilirubin adsorption, serum total bilirubin decreased from (409 ± 137) μmol/L to (298 ± 107) μmol/L(P<0.05), and serum direct bilirubin decreased from (321±100) μmol/L to (166±111) μmol/L(P<0.01). Transaminase, serum total protein, albumin, INR, platelet count, white blood cell count, hemoglobin, urea nitrogen, creatinine had no statistical difference between before and after treatment, (P > 0.05). In 11 patients, bilirubin adsorption was treated 22 sessions, 8 patients were treated 1 session, and 3 patients were treated 2 sessions, 5 sessions, and 7 sessions respectively. The decrease rate of serum total bilirubin was 2.8% ~ 47.6%. 4 patients survived, 7 patients died, and the survival rate was 36%. No treatment-related side effects happened during the treatment.
        CONCLUSION  The bilirubin adsorption is effective and safe in the treatment of acute liver failure after cardiac surgery.

       

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