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急性肝衰竭:诊断与管理

Acute Liver Failure: Diagnosis and Management.

作者信息

Punzalan Carmi S, Barry Curtis T

机构信息

1 Department of Medicine, Division of Gastroenterology, University of Massachusetts Memorial Medical Center, Worcester, MA, USA.

出版信息

J Intensive Care Med. 2016 Dec;31(10):642-653. doi: 10.1177/0885066615609271. Epub 2016 Jul 9.

Abstract

Acute liver failure is life threatening liver injury with coagulopathy and hepatic encephalopathy within 26 weeks and generally, in the absence of preexisting liver disease. Fulminant liver failure occurs when hepatic encephalopathy occurs within 8 weeks of jaundice. The majority of patients with ALF are women with the median age of 38 years. In the United States, drug induced liver injury including acetaminophen causes the majority of ALF cases. The etiology of ALF should be determined, if possible, because many causes have a specific treatment. The mainstay for ALF is supportive care and liver transplantation, if necessary. There are multiple prognostic criteria available. Prognosis can be poor and patients should be referred to a liver transplantation center as soon as possible.

摘要

急性肝衰竭是一种危及生命的肝损伤,在26周内出现凝血功能障碍和肝性脑病,且通常不存在先前存在的肝脏疾病。暴发性肝衰竭是指黄疸出现后8周内发生肝性脑病。大多数急性肝衰竭患者为女性,中位年龄为38岁。在美国,包括对乙酰氨基酚在内的药物性肝损伤是急性肝衰竭病例的主要病因。如果可能的话,应确定急性肝衰竭的病因,因为许多病因都有特定的治疗方法。急性肝衰竭的主要治疗方法是支持治疗,必要时进行肝移植。有多种预后标准可供参考。预后可能很差,患者应尽快转诊至肝移植中心。

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