The clinical study of treatment with continuous renal replacement therapy in severe hepatitis with hepatic encephatopathy

Objective To evaluate the clinically value and to investigate therapeutic mechanising of the treatment with continuous renal replacement therapy in severe hepatitis with hepatic encephalopathy.Metfaod Forty - seven cases were randomly allocated into three groups: CRRT group ^PE( plasma exchange) -I- CRRT group and basic treatment group.The former two groups were respectively operated by CRRT or PE + CRRT with basic treatment.Serum biochemical tests,amirKK TNFa and IL- 6 were detemined before and after treatment with CRRT.Result 75.0% patients in CRRT group and 86.7% patients in PE + CRRT group regained normal consciousness,but in basic treatment group31.3% achieved a normal neurologic recovery (P 0.05).The survival rate of patients in CRRT group^PE + CRRT group and basic treatment group were respectively 25.0% ,46.7% and 6.25%(P0.05).It showed that renal function and serum amino were significantly improved after treatment with CRRT,serum TNFa and EL - 6 decreased ( P 0.05).There were no changes in levels of serum bilirubin and total bile acid.The hemodynamic function was kept stable and there were no complications during the CRRT therapy.The survival rate of patients was associated with the degree of hepatic encephalopathy in CRRT group and PE + CRRT group ( P 0.05).Conclusion Our results showed that CRRT is an efifective means in treating severe hepatitis with hepatic encephalopathy and obviously increase the survival rate if it combined with PE in early hepatic encephalopathy.