急性至慢性肝衰竭-目前的管理和未来的前景
Benedict Allhoff1, Christoph Neumann-Haefelin1, Philipp Kasper1
1Department of Gastroenterology and Hepatology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany.
Biomedicines
|September 27, 2025
概括
急性至慢性肝衰竭 (ACLF) 是一种严重的疾病,死亡率高. 标准化定义和基于证据的治疗方法,包括肝移植和新疗法,对于改善患者的治疗结果至关重要.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 移植医学 移植医学
- 临界护理医学 临界护理医学
背景情况:
- 急性至慢性肝衰竭 (ACLF) 呈现为慢性肝病与器官衰竭的急性减补,导致高短期死亡率.
- 缺乏标准化的国际定义使ACLF的诊断和管理变得复杂.
- 越来越多的临床相关性需要全面了解ACLF.
研究的目的:
- 提供当前ACLF定义和致病机制的全面概述.
- 审查ACLF的催化事件和当前治疗策略.
- 讨论ACLF患者肝移植的作用和选择标准.
主要方法:
- 对当前ACLF定义,病原和治疗方法的文献综述.
- 分析肝移植在ACLF中的作用.
- 评估新的预后评分系统和新兴疗法.
主要成果:
- ACLF的定义各不相同,影响患者管理和研究.
- 肝移植是一种潜在的治疗选择,但由于高的外科手术风险,患者选择面临挑战.
- 新的评分系统 (例如,TAM核心,SALT-M) 和新兴的治疗方法 (例如,体外支持,免疫调节) 是有希望的,但需要进一步的临床验证.
结论:
- 对于ACLF,迫切需要协调的定义和基于证据的治疗框架.
- 优化肝移植患者的选择至关重要.
- 新兴的辅助疗法需要进一步调查,以改善ACLF患者的护理和生存率.
相关概念视频
Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow
214
Chronic liver disease significantly impacts drug metabolism due to alterations in hepatic blood flow and enzyme accessibility. This disruption affects the body's pharmacokinetics—the movement and processing of drugs within the system. Key enzymes crucial for metabolizing medications become less accessible, changing how drugs are processed and utilized. Furthermore, liver disease influences the synthesis of plasma proteins, such as albumin and globulins, which play critical roles in drug...
214
Acute Pancreatitis II: Clinical Manifestations and Management
756
Acute pancreatitis presents a complex medical emergency characterized by rapid onset inflammation of the pancreas, demanding timely diagnosis and management to prevent complications. The condition primarily manifests through severe upper abdominal pain that often radiates to the back. This pain intensifies following the consumption of fatty foods. Accompanying symptoms such as nausea, vomiting, abdominal distention, fever, dyspnea, cyanosis, and jaundice can vary in intensity but significantly...
756
Chronic Pancreatitis II: Collaborative Care
313
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:
313
Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test
185
In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess...
185
Esophageal Varices-II: Clinical Features and Management
374
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...
374
Acute Kidney Injury VI: Nursing Management
392
Acute Kidney Injury (AKI) results in an inability to maintain fluid, electrolyte, and acid-base balance. Effective nursing management is critical in improving patient outcomes and includes comprehensive patient assessment and targeted interventions.Comprehensive Patient AssessmentA detailed history collection is essential, focusing on any recent infections, nephrotoxic medication use, or chronic conditions such as hypertension and diabetes that may contribute to AKI. During the physical...
392


