在重症监护病房患者的肝脏活检和急性肝病学
Lukas Mätzold1, Florian Roßner2, Frank Tacke1
1Department of Hepatology & Gastroenterology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Expert review of gastroenterology & hepatology
|June 16, 2025
概括
肝脏活检可以帮助诊断和治疗决定的严重肝脏疾病,如急性肝功能衰竭在ICU. 由于较低的风险和足够的组织样本,往往更喜欢过关节活检.
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
- 诊断程序 诊断程序 诊断程序
背景情况:
- 患有严重肝病的患者,如急性肝衰竭 (ALF),酒精相关性肝炎 (AAH) 和急性至慢性肝衰竭 (ACLF),通常需要重症监护室 (ICU) 管理.
- 关于肝脏活检的必要性和时间对于ICU环境中的诊断和治疗存在不确定性.
研究的目的:
- 审查肝活检在ICU内诊断肝功能障碍和器官衰竭中的作用.
- 总结国际指导指示,首选的活检技术,以及来自第三级肝脏中心的临床经验.
主要方法:
- 审查关于肝活检指示的国际指导方针.
- 首选的肝脏活检技术的概述 (横,迷你腹腔镜,EUS指导).
- 包括来自专业肝脏病学中心的临床经验.
主要成果:
- 肝脏组织学可以对包括ALF,AAH,自身免疫性肝炎和ACLF在内的疾病的预后评估和治疗决策有好处.
- 穿性肝脏活检通常优先于穿皮方法,因为手术风险较低,组织产量足够.
- 迷你腹腔镜或EUS导向活检是潜在的替代方案.
结论:
- 肝衰竭的诊断工作应在专门的肝病学中心进行.
- 肝活检解释需要考虑临床背景和中心专业知识.
- 由于肝脏活检在重症监护医学的科学证据稀缺,需要进一步的研究.
关键词:
肝脏活检活检是什么意思急性肝衰竭 (ALF) 是一种严重的肝衰竭.急性至慢性肝功能衰竭 (ACLF)与酒精有关的肝炎 (AAH)内镜超声波 (EUS) 的使用重症监护室的重症监护室是重症监护室的重症监护室.肝移植 (LT) 是一种肝移植.更多相关视频
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