Treatment of severe hepatitis by HA neutral macroporous resin hemoperfusion: an analysis of 40 cases

AIM: To investigate the efficacy of hemoperfusion with HA neutral macroporous resin in the treatment of severe hepatitis, and to find out the important nursing points to get better results. METHODS: A total of 40 severe hepatitis patients were treated by HA neutral macroporous resin (HA330-II) hemoperfusion (96 times in total). The symptoms, signs, liver function, renal function, prothrombin activity (PTA), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) levels were analyzed before and after treatment. Venous cannula or venepuncture was used to set up blood circulation. RESULTS: After hemoperfusion, the symptoms and signs were improved to different extents in most of the patients; the levels of ALT, TBIL, DBIL were decreased significantly (92.3 ± 53.1 IU/L vs 176.8 ± 120.2 IU/L; 283.2 ± 90.2 μmol/L vs 363.0 ± 140.3 μmol/L; 122.8 ± 71.7 μmol/L vs 247.5 ± 106.4 μmol/L; all P < 0.01); PTA was increazed (39.6% ± 12.5% vs 29.2% ± 14.8%, P < 0.01). Meanwhile, the levels of IL-6 and TNF-α were decreased (27.6 ± 22.5 ng/L vs 88.5 ± 32.8 ng/L, 0.47 ± 0.4 μg/L vs 0.83 ± 0.6 μg/L; both P < 0.01) after hemoperfusion. Of the 40 patients, 29 cases recovered (72.5%); 3 cases were found without improvements and discharged from hospital (7.5%); 8 cases died (20%). Thirty-six patients (90%) finished hemoperfusion by venepuncture and 4 patients (10%) by venous cannula. CONCLUSION: HA resin hemoperfusion is able to remove toxins in patients with severe hepatitis, and improve the clinical symptoms and signs to some extent. Full preparation, skillful techniques, close observation and timely treatment of side effects contribute to a favorable efficacy.