手術後嚴重黃疸之選擇性膽紅素吸附血漿灌流療法：一例報告

Selective Bilirubin－Adsorption Plasma Perfusion Tzherapy for Severe Postoperative Jaundice；Report of A Case

我們報告一例冠狀動脈繞道手術後因敗血症合併急性膽汁鬱滯及急性腎衰竭案例。敗血症發病兩週後，血中總膽紅素值持續惡化至31.6mg/Dl，而同時併隨多病源性癲癇發作。此時，利用膽紅素吸附管進行連續3次的血漿灌流療法，在除去體內46%總膽紅素之後，臨床上癲癇發作也逐漸改善。因此，選擇性膽紅素吸附療法對手術後嚴重黃疸案例之血中膽紅素之移除頗有助益。

We report a case of acute cholestasis and renal failure due to sepsis after coronary bypass surgery. Progressively deteriorating hyperbilirubinemia(up to 31.6mg/dL)developed accompanied by multifocal seizures,two weeks after the onset of sepsis. A total of three sessions of plasma perfusion with a bilirubin-adsorption column removed 46％ of the total serum bilirubin and helped control the seizures. Selective bilirubin adsorption therapy may be beneficial for removing serum bilirubin in patients with postoperative jaundice.