Hemodiabsorption in treatment of acute hepatic failure and chronic cirrhosis with ascites.
Hemodiabsorption in treatment of acute hepatic failure and chronic cirrhosis with ascites.
复制标题
血液吸收吸收治疗急性肝衰竭和慢性肝硬化腹水。
DOI：
10.1111/j.1525-1594.1994.tb02216.x
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发表时间：
1994
影响因子：
2.4
通讯作者：
S. Ash
中科院分区：
文献类型：
--
作者：
S. Ash
血液吸收是一种选择性的化学去除过程，在此过程中，血液通过被悬浮的细小吸着剂颗粒包围的透析膜包裹。生物-DT系统包含悬浮液中的木炭和阳离子交换器，该悬浮液通过纤维素膜板式透析器的透析液空间。该系统已被证明在治疗严重药物过量的患者中有效，并在治疗因肝功能衰竭而导致的4期昏迷方面显示出积极的效果。最近，在这个系统中的木炭上预装了支链氨基酸，以便在去除芳香氨基酸的同时将这些氨基酸返回给患者。进一步的改进包括在预充液和吸着剂中添加渗透活性物质，以增加血液的肿胀压力，并将腹水转移到血液中，同时超滤将液体转移出血液。这些改进的临床测试现在开始在因慢性肝功能不全和肝硬变而导致的腹水和脑病患者身上进行。未来的改进将包括蛋白质渗透膜，以增加蛋白质结合毒素的去除，以及在血液透析吸收单元下游增加肝细胞。
Hemodiabsorption is a selective chemical removal process during which blood passes through dialysis membrane packages surrounded by a suspension of fine sorbent particles. The BioLogic-DT system contains charcoal and cation exchangers in a suspension that passes through dialysate spaces of a cellulosic membrane plate dialyzer. The system has proven effective in treatment of patients with serious drug overdose and has demonstrated positive effects in treatment of stage 4 coma due to hepatic failure. Recently, the charcoal in this system has been preloaded with branch chain amino acids to return these acids to patients while aromatic amino acids are removed. Further improvements include addition of osmotically active agents to the priming fluid and sorbent to increase blood oncotic pressure and transfer of ascitic fluid to blood while ultrafiltration transfers fluid out of the blood. Clinical testing of these improvements is now beginning in patients with ascites and encephalopathy due to chronic hepatic insufficiency and cirrhosis. Future improvements will include protein permeable membranes to increase removal of protein-bound toxins and addition of hepatic cells downstream from the hemodiabsorption unit.