连续肾脏替代治疗肝硬化合并肝性脑病的临床效果

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Abstract Objective To explore the clinical effect of continuous renal replacement therapy (CRRT) in the treatment of cirrhosis patients complicated with hepatic encephalopathy (HE). Methods A total of 60 patients with cirrhosis complicated with HE from February 2018 to June 2019 were enrolled in the study. They were divided into the control group(32 cases) and the observation group (28 cases) according to the randomized grouping method. The control group was treated with routine liver care and anti-hepatic coma therapy. The observation group was treated with routine liver care and anti-hepatic coma therapy, and added the CRRT. The blood ammonia、interleukin-6 (IL-6), interleukin-10 (IL-10),tumor necrosis factor-α(TNF-α) levels and the prothromb in time (PT) of the two groups were compared at the time of admission and after treatment of 24 h. The time of mental conversion and mortality of the two groups were compared.Results The levels of blood ammonia, IL-6, IL-10 and TNF-α of the two groups were compared before treatment, and the difference was not statistically significant (P＞0．05). After treatment, the levels of blood ammonia, IL-6, IL-10 and TNF-α in the observation group were lower than those before treatment (P＜0.05). Before and after treatment, there was no significant difference in the levels of the blood ammonia, IL-6, IL-10 and TNF-α in the control group (P＞0．05).The levels of blood ammonia, IL-6, IL-10 and TNF-α of the two groups were compared after treatment, and the observation group was lower than those in the control group, the differences were statistically significant (P＜0.05). The which in time of mental conversion and hospitalization of the patients in the observation group were shorter than that of the control group, and the mortality rate in the observation group was lower than that of the control group, the differences were statistically significant (P＜0.05). The PT of the two groups was compared before treatment, there was not statistically significant (P＞0．05); the PT of the two groups was compared before and after treatment, and there was not statistically significant (P＞0．05); the PT of the two groups was compared after treatment, there was not statistically significant(P ＞0．05). Conclusion CRRT treatment can effectively reduce the levels of the blood ammonia, IL-6, IL-10 andTNF-α in patients with cirrhosis and HE, shorten the time of mental conversion and hospitalization, and reduce the mortality. CRRT treatment has no obvious effect on the PT.

Key words： Cirrhosis Hepatic encephalopathy Interleukin-6 Interleukin-10 Tumor necrosis factor-α Continuous renal replacement therapy

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