[慢性肝衰竭的急性:不仅仅是肝硬化不补偿]
Clément Nussbaumer1, Antoine Chapot1, Mallory Moret Bochatay1
1Service de médecine interne et de soins intensifs, Groupement hospitalier de l'Ouest lémanique, 1260 Nyon.
Revue medicale suisse
|September 6, 2024
概括
急性至慢性肝衰竭 (ACLF) 涉及严重的器官损伤和肝硬化患者的高死亡率. 由于治疗选择有限和预后不佳,早期治疗和支持性护理至关重要.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 关键护理医学 关键护理医学
- 内部医学 内部医学
背景情况:
- 急性至慢性肝衰竭 (ACLF) 代表了肝硬化疾病的严重进展.
- 与非补偿性肝硬化相比,ACLF的特点是多器官损伤和显著更高的短期死亡率.
研究的目的:
- 总结目前对ACLF病理生理学,诊断和管理的理解.
- 要突出早期干预和ACLF患者的支持性护理的关键需求.
主要方法:
- 对ACLF现有文献的审查.
- 分析病理生理机制,特别是系统性炎症的作用.
- 对ACLF与败血症进行预后评分和管理策略的比较.
主要成果:
- ACLF的病理生理是由强烈的全身炎症驱动的,通常是由可识别的因素,如感染或毒素引发的.
- 预后得分,类似于败血症,有助于评估器官损伤和指导患者管理.
- 目前的治疗主要是支持性,重点是器官支持.
结论:
- 由于其预后不佳,ACLF需要密切监测和早期管理讨论.
- 与败血症的类比为患者分层和护理提供了宝贵的见解.
- 对ACLF的有效治疗方法进行进一步的研究是有必要的.
相关概念视频
Chronic Pancreatitis I: Introduction
84
The pancreas, an elongated and flat gland situated behind the stomach, serves a vital function in digesting food and managing blood sugar levels.
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
84
Esophageal Varices-II: Clinical Features and Management
57
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
57
Chronic Bowel Disorders: Introduction
414
Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
414
Chronic Pancreatitis II: Collaborative Care
77
The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:
Assessment:
77
Acute Respiratory Failure-III
163
Hypercapnic respiratory failure, also known as Type 2 or ventilatory respiratory failure, is a severe condition characterized by the body's inability to effectively remove carbon dioxide (CO2) from the bloodstream. It leads to an arterial CO2 pressure (PaCO2) exceeding 45 mmHg and a blood pH above 7.35. This situation indicates that the body's ventilatory demand, or the ventilation needed to maintain normal PaCO2 levels, surpasses its supply or the maximum gas flow achievable without...
163
Diseases of the Liver and Gallbladder
488
Liver and gallbladder diseases are a significant health concern, with prominent conditions including cirrhosis, hepatitis, non-alcoholic fatty liver disease (NAFLD), and gallstones. Jaundice is a common manifestation of liver and biliary disease.
Cirrhosis is characterized by the scarring of hepatic lobules in the liver, which are replaced by fibrous tissue, affecting the liver's normal functioning. NAFLD, on the other hand, is caused by an excessive build-up of fat in the liver, not...
Cirrhosis is characterized by the scarring of hepatic lobules in the liver, which are replaced by fibrous tissue, affecting the liver's normal functioning. NAFLD, on the other hand, is caused by an excessive build-up of fat in the liver, not...
488


