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目的探讨MARS联合血浆置换救治妊娠急性脂肪肝的疗效。方法对东南大学医学院附属南京市第二医院6例妊娠急性脂肪肝给以MARS联合血浆置换治疗,并在治疗前后测定肝、肾功能、电解质、血氨及血糖。结果经MARS联合血浆置换治疗后高胆红素血症得到明显缓解,总胆红素、直接胆红素均有明显下降,血浆白蛋白升高、凝血酶元时间缩短,凝血酶原活动度升高,患者的临床症状明显改善,浮肿消退,食欲增加,精神好转,血肌酐和尿素氮清除率显著,肝性脑病缓解。结论MARS联合血浆置换救治妊娠急性脂肪肝展示了其独特的优势,提供了重要的内环境的稳定、平衡。
Objective To investigate the effect of MARS combined with plasma exchange in the treatment of acute fatty liver in pregnancy. Methods Six cases of pregnancy-induced acute fatty liver in Nanjing Second Affiliated Hospital of Southeast University were treated with MARS combined with plasma exchange. Liver and kidney function, electrolytes, blood ammonia and blood glucose were measured before and after treatment. Results After MARS combined with plasma exchange therapy, hyperbilirubinemia was relieved obviously, total bilirubin and direct bilirubin were significantly decreased, plasma albumin was increased, thrombin time was shortened, prothrombin activity was increased High, the patient’s clinical symptoms improved significantly, edema subsided, increased appetite, improved mental status, serum creatinine and urea nitrogen clearance significantly, hepatic encephalopathy alleviated. Conclusions MARS combined with plasma exchange for the treatment of acute fatty liver in pregnancy demonstrates its unique advantages and provides important stability and balance of internal environment.