[致命的过程:当植物影响肝脏时]
Lisa van der Lely1, Rea Andermatt1, Barbara Lienhardt2
1Universitätsspital Zürich, Institut für Intensivmedizin, Zürich, Schweiz.
Deutsche medizinische Wochenschrift (1946)
|March 14, 2025
概括
这一案例突显了中国草药引起的急性肝衰竭 (ALF) 在以前健康的患者身上. 及时识别和移植转诊对于管理ALF至关重要,因为延迟治疗导致了致命的结果.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 毒理学 毒理学 毒理学
- 内部医学 内部医学
背景情况:
- 一名55岁的老人出现了黄,在使用中国草药4个月后表现下降.
- 临床症状包括黄,右上象限疼痛和I级肝脑病变 (HE).
- 最初的实验室工作显示出凝血病,升高的转氨基酶和胆固醇与最小的超氨血症.
研究的目的:
- 报告一种归因于中国草药的急性肝衰竭病例.
- 强调及时诊断和管理ALF的重要性.
- 为了强调急需立即转移肝脏移植的关键需求.
主要方法:
- 对疑似药物诱导的肝损伤患者的病例报告分析.
- 临床检查,实验室测试 (肝功能测试,凝血概况,氨水平) 和腹部超声波.
- 关于草药补充剂摄入量和症状进展的患者病史的审查.
主要成果:
- 急性肝衰竭 (ALF) 的诊断是基于临床表现,实验室发现和与中国草药消费的时间关联而建立的.
- 图像检查排除了潜在的肝纤维化,肝硬化或 perfusion 障碍.
- 由于患者的矛盾性导致的肝移植推迟转诊导致了移植失败和移植后的致命结果.
结论:
- 中国草药可以诱导急性肝衰竭 (ALF),即使在以前健康的个体.
- 及时识别ALF (定义为HE和INR≥2) 和迅速转诊到移植中心对于改善患者的治疗结果至关重要.
- 在移植后的治疗过程中,可能会出现腹腔综合征和血栓栓塞等并发症,这凸显了ALF病例的复杂性.
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