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The 36-year-old Ms. Wang (pseudonym) had a difficult pregnancy, and after going through hardships, she finally succeeded in artificial IVF and became pregnant with twins.
As a first-time mother, she enjoyed the joy of pregnancy, but she did not expect that a great danger was quietly approaching her.
01
Liver function indicators have soared
The lives of the mother and baby were hanging by a thread
It turned out that Ms. Wang was a hepatitis B carrier, and her liver function had been normal during the pre-pregnancy examination. It wasn't until the tenth week of pregnancy that the prenatal check-up found that the liver function was mildly abnormal, and she took liver protection drugs to no avail.
Soon, Ms. Wang's liver function was obviously abnormal, and the aminotransferase once rose to 1600U/L, and she immediately came to the Department of Infectious Diseases of Hangzhou First People's Hospital.
After Jin Jie, director of the Department of Infectious Diseases, learned more about the condition, the team of the Department of Infectious Diseases immediately administered anti-hepatitis B virus treatment for the patient.
At the time of admission, the patient's liver function deteriorated dramatically, meeting the diagnostic criteria for acute-on-chronic liver failure. It can be said that the lives of the mother and baby are hanging by a thread.
02
Treatment is in a dilemma
Artificial liver treatment brings life
The Department of Infectious Diseases quickly initiated the discussion of difficult cases of critically ill pregnant women, and multidisciplinary consensus was that the patient's current liver failure, poor coagulation function, and the risk of aggravated liver damage and massive bleeding from termination of pregnancy were not the best choice.
After careful consideration by the multidisciplinary team, the artificial liver therapy team of the Department of Infectious Diseases decided to immediately administer artificial liver therapy to the patient.
Elderly pregnant women with twins with hyperthyroidism, thrombophilia, acute-on-chronic liver failure, and pulmonary infection during pregnancy······ These symptoms are worrying to everyone, and the road to treatment is difficult.
After 7 times of symptomatic supportive treatment with artificial liver and liver protection and enzyme lowering, the patient's condition gradually stabilized. After more than 50 days of treatment, the pregnant woman's liver function indicators gradually recovered, and the fetal B ultrasound was rechecked every week, and the two fetal indicators were stable, and the mother and baby were discharged safely.
03
What is an artificial liver?
These conditions are amenable to artificial liver therapy
The artificial liver support system is based on the strong regeneration ability of hepatocytes, through an in vitro mechanical, physicochemical and biological device, to remove various harmful substances, replenish essential substances, improve the internal environment, temporarily replace part of the function of the failing liver, create conditions for hepatocyte regeneration and liver function recovery or wait for the opportunity for liver transplantation.
Artificial liver support systems are divided into biological artificial liver, non-biological artificial liver and mixed artificial liver. Non-biological artificial liver is currently the most widely used, which has been widely used in clinical practice and has been proven to have clear efficacy.
What conditions can be treated with artificial livers?
Liver failure: patients with early, early, and intermediate liver failure should be advised; Patients with advanced liver failure waiting for a donor before liver transplantation, rejection after liver transplantation, and non-functional liver transplantation.
Complications of liver failure: hepatic encephalopathy, hepatorenal syndrome, water and electrolyte imbalances, systemic inflammatory response syndrome.
Hyperbilirubinemia caused by various causes: drug-induced, autoimmune, and hyperbilirubinemia after surgery.
Infectious diseases and others: any infectious disease that produces cytokine storm (such as bacterial infection, viral infection), tumor lysis syndrome, multiple organ failure, severe lupus erythematosus, myasthenia gravis, Guillain-Barré syndrome, rheumatic diseases, blood group incompatibility pregnancy, multiple myeloma, hypercholesterolemia, acute pancreatitis, etc.
Jin Jie, Chief Physician
Director of the Department of Infectious Diseases of Hangzhou First People's Hospital, National Member of the National Severe Liver Disease and Artificial Liver Blood Purification Collaboration Group, Member of the Liver Failure and Artificial Liver Group of the Infectious Diseases Branch of the Chinese Medical Association, Vice Chairman of the Hepatology Professional Committee of the Zhejiang Association of Mathematical and Physical Medicine, and Vice Chairman of the Infectious Disease Professional Committee of the Zhejiang Association of Integrative Traditional and Western Medicine. He is good at the rescue of severe hepatitis, liver failure, liver cirrhosis and its complications, the treatment of refractory ascites and refractory jaundice, pregnancy complicated with abnormal liver function, various infectious diseases and fever to be investigated.
Outpatient Hours (Hangzhou First People's Hospital)
Lakeside Campus:
Monday afternoon, famous doctor outpatient clinic
Tuesday afternoon Pregnancy and Liver Disease Joint Clinic
Wednesday morning Specialist Clinic
Wednesday afternoon Fatty liver metabolism combined clinic
Chengbei Campus:
Friday morning Specialist Clinic
Xiasha Campus:
Tuesday morning, once a half month
- Contributed by: Hangzhou First People's Hospital
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