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入住重症监护病房的患者急性肝衰竭-维也纳回顾性单中心分析

Patrick Haselwanter¹, Seanna Fairfield¹, Marlene Riedl-Wewalka¹

¹Department of Medicine III, Division of Gastroenterology and Hepatology, Intensive Care Unit 13H1, Medical University of Vienna, Vienna, Austria.

Wiener klinische Wochenschrift

|May 26, 2025

概括

急性肝衰竭 (ALF) 需要重症监护室 (ICU) 管理和及时的高紧急肝移植 (HU-LTx). HU-LTx显著提高了ALF患者的生存率,强调了早期转移到专门中心的重要性.

科学领域:

肝病学肝病学是一种肝病学.
密集护理医学密集护理医学
移植手术移植手术

背景情况:

急性肝衰竭 (ALF) 是一种具有高死亡率的严重医疗紧急情况.
迅速进入重症监护室 (ICU) 和对紧急肝移植 (HU-LTx) 的评估对于生存至关重要.
关于ALF的流行病学数据,特别是在中欧,仍然有限.

研究的目的:

调查进入ICU的ALF患者的流行病学和结果.
评估HU-LTx在改善ALF患者生存率方面的有效性.
确定中欧地区ALF的主要原因.

主要方法:

对2012年至2024年在维也纳综合医院重症监护室 (ICU) 住院的ALF患者进行了回顾性单中心研究.
对患者人口统计,ALF病因,ICU停留时间和死亡率的分析.
在接受HU-LTx和没有接受HU-LTx的患者之间的生存率的比较.

主要成果:

包括31名ALF患者;常见的原因是病毒感染 (26%),自身免疫性肝炎 (16%),和药物诱导的肝损伤 (DILI,10%).
整体ICU存活率为61%;然而,接受HU-LTx的患者的存活率明显高 (28天后92%;6个月后85%).
在42%的患者中进行了HU-LTx,这表明它在治疗严重ALF方面发挥了关键作用.

结论:

病毒感染,自身免疫性肝炎和DILI是中欧地区ALF的主要原因.
非常紧急的肝移植对于改善ALF患者的存活率至关重要.
有效的ICU管理和早期转诊到肝移植中心对于优化ALF患者的治疗结果至关重要.

关键词:

关键的护理关键的护理流行病学流行病学肝病学肝病学是一种肝病学.肝功能衰竭肝功能衰竭肝脏移植肝脏移植

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