血浆置换联合持续性血液透析滤过治疗小儿急性肝功能衰竭的临床应用

摘要

急性肝功能衰竭病因复杂，病情进展迅速，单纯保肝治疗病死率高，是儿科临床危重症。人工肝支持治疗系统是目前治疗急性肝功能衰竭的重要手段，它主要借助一种体外的机械、理化或生物的装置，清除患者体内蓄积的各种有毒物质，暂时替代肝脏的部分代谢、解毒或合成功能，为肝细胞再生及进一步的临床治疗赢得宝贵时间。由于不同血液净化模式的局限性，人工肝支持治疗系统多采用组合式血液净化模式。该文主要对血浆置换联合持续性血液透析滤过治疗小儿急性肝功能衰竭的效果作一综述。%Acute liver failure is a pediatric clinical critical disease with complex etiology,rapid progress and medical treatment,contributing to a high fatality rate. Artificial liver support system can remove a variety of toxic substances through mechanical,physicochemical or biological device to replace part of liver function like metabolism,detoxification,or synthesis temporarily to win precious time for liver cell regeneration and further clinical therapy,which has become an important treatment of acute liver failure at present. Considered the limita-tions of different blood purification mode,combined mode of blood purification is mostly applied in clinical ther-apy. This article aims to review the effect of plasma exchange combined with continuous veno-venous hemodial-ysis/filtration for the treatment of children with acute liver failure.