摘要目的 观察经外周静脉异体骨髓间充质干细胞移植治疗慢加急性乙型肝炎肝衰竭的疗效及护理特点.方法 经外周静脉行异体骨髓间充质干细胞移植术治疗45例慢加急性乙型肝炎肝衰竭的患者,以46例单纯内科综合治疗的患者为对照,分析12周患者存活情况和肝功能的变化,并针对手术不同时期进行整体护理.结果 患者的12周存活率为75.6％(34/45),高于对照组的52.2％(24/46),干细胞治疗胆红素和凝血功能有明显改善.结论 异体骨髓间充质干细胞移植可提高慢加急性乙型肝炎肝衰竭患者的生存率,术前的心理护理,熟练的技术操作,术后的精心护理和病情观察有利于移植后患者的康复.

abstractsObjective Our research aimed to investigate the efficacy and the nursing characteristics of allogenic bone marrow mesenchymal stem cell (BM-MSCs) transplantation in HBV related acute-on-chronic liver failure (ACLF) patients.Methods A total of 91 HBV related ACLF patients were enrolled,among whom 45 patients received allogenic BM-MSCs transplantation via peripheral vein and other 46 patients received medical treatment only.We assessed the 12-week survival rates and the variation of model for end liver disease (MELD) score.Besides,we administrated comprehensive nursing for these patients in different stages of the transplantation.Results The cumulated survival of patients received BM-MSC transplantation was 75.6％,which was higher than the control group (54.5％).The level of total bilirubin and International Normalized Ratio (INR) had greatly improved.41 of 45 patients passed through perioperative period safely,without any severe adverse events.11 patients died due to exacerbation of liver failure,among whom 3 happened in perioperative period.But none was related with the operation.Conclusions Allogenic BM-MSCs transplantation can improve the survival rate of HBV related ACLF patients.The psychological nursing pre-operation,skilled operation,intensive care and observation post operation were beneficial to the patients' recovery after transplantation.