Substantiation of complex intensive treatment of hepatic failure, complicated by encephalopathy
Ivachevsky, M.M.; Ivachevska, V.V.
Wiadomosci Lekarskie 71(2 Part 1): 361-365
2018
ISSN/ISBN: 0043-5147 PMID: 29729174 Document Number: 695064
Introduction: Thesis is devoted to the optimization of complex intensive therapy of hepatic insufficiency, complicated by encephalopathy. The aim: Optimization of treatment efficacy in patients with hepatic insufficiency complicated by encephalopathy. Materials and methods: The results of complex examination and treatment of 73 patients with hepatic insufficiency have been studied and analyzed in this work. The study included patients who had been hospitalized with liver encephalopathy, which developed on the background of hepatic failure, cirrhosis of the liver in particular. Results:Patients with hepatic insufficiency are one of the most difficult groups in the treatment and prevention of the progress of the disease. Extracorporal methods of detoxification improve clinical symptoms, reducing the overall intoxication of the body. In addition, the severity of the manifestations of hepatic encephalopathy decreases and there is an opportunity to continue and improve the quality of life of patients. Plasmasorption with albumin is most effective treatment of patients with sub- and decompensated cirrhosis. Conclusions: It has been established that membrane plasmapheresis does not reduce liver encephalopathy, in contrast to hemosorption and plasma sorption with albumin, increases the gamma-globulin level, does not affect hepatic transaminases. All used techniques increase the level of IgG and circulating immune complexes and reduce the leukocyte index of intoxication. At the same time, none of the used methods of extracorporeal detoxification did not lead to changes in the mass of functioning hepatocytes.