Clinical Research of Hemoperfusion in Treatment of Acute Liver Failure

Objective To discuss the clinical effect of hemoperfusion on acute liver failure(ALF).Methods Twenty-six ALF patients were randomized into groups A(n=16) and B(n=10).Group B were asked to rest in bed absolutely and given a high-carbohydrate,low-fat and adequate protein diet,acetic acid retention enema,appropriate addition of albumin or fresh plasma,intravenous infusion of GSH,glycyrrhizic acid diamine and polyene phosphatidylcholine,proper use of antibiotics,coagulation factors,immune regulation and anti-endotoxin based on patients′ conditions,to prevent positively such complications as hepatic encephalopathy and cerebral edema.Group A,besides conventional treatment,given additional hemoperfusion,2～6 times,every 2～4 d.Before treatment and next morning after,fasting venous blood were collected to determine serum endotoxin,TNF-α,IL-6,liver and kidney function,electrolytes,prothrombin activity(PTA),ammonia,blood routine examination and changes of clinical symptoms.Results After hemoperfusion treatment,the clinical symptoms of patients were improved remarkably,and the levels of TBIL,ALT,ammonia,BUN,Scr,PLT,LPS,TNF-α,IL-6 lowered and PTA increased as compared with pretreatment,but only ammonia level lowered in group B,the difference was significant(P0.05).Conclusion Hemoperfusion,absorbing LPS,TNF-α,IL-6,bilirubin,ammonia,etc.and improving liver and kidney function and clinical symptoms,is a safe and effective method of rescuing ALF.