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药理管理用于预防和治疗肝切除术后的肝衰竭

Arja Gerritsen¹, Marieke T de Boer¹, Carlijn I Buis¹

¹Department of Surgery, Section of Hepatobiliary Surgery and Liver Transplantation, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.

Digestive surgery

|October 17, 2025

概括

肝切除术后肝衰竭 (PHLF) 是肝切除后的主要风险. 虽然外科期间的葡萄皮质激素可能有助于选择患者,但其他药物缺乏已证明的疗效,因此需要进一步的临床试验来预防和治疗PHLF.

科学领域:

肝胆道手术肝胆道手术
药理学药理学是指药理学的学科.
关键护理医学关键护理医学

背景情况:

肝切除术后肝衰竭 (PHLF) 是肝切除后死亡的重要原因.
目前对PHLF的治疗选择有限,这推动了对新治疗策略的研究.
针对缺血-再输液损伤和门户流量的药理干预是感兴趣的领域.

研究的目的:

审查目前关于PHLF药理管理的证据.
为医疗保健专业人员提供临床上适用的概述.
确定潜在的治疗策略,以预防和治疗PHLF.

主要方法:

对PHLF药理学剂的现有文献进行系统审查.
对临床前和临床研究数据的分析.
对包括葡萄糖皮质类药物,N-乙半氨酸,欧米茄-3脂肪酸,索马托斯塔丁,特里普林素,β-阻断剂,肝素和高胰岛素血糖-正常血糖策略在内的药物的证据评估.

主要成果:

周围的皮质糖类药物可能会降低特定患者群体的PHLF发病率.
N-乙半氨酸和omega-3脂肪酸没有证明PHLF的临床疗效.
索马托斯塔丁和特里普林素显示有前途,但需要进一步随机试验验证.
由于肝脏再生受损,不推使用非选择性β-抑制剂.
早期的肝素和高胰岛素-高血糖-正常血糖策略显示出潜力,但需要更多的研究.

结论:

在经过精心挑选的患者中,外科皮质糖类可以为PHLF预防提供好处.
目前,大多数药理学药物缺乏足够的证据来支持常规PHLF管理.
未来的临床试验对于建立有效的PHLF药理疗法至关重要.

关键词:

药物药物药物是一种药物.管理管理管理管理肝切除术后的肝功能衰竭预防预防预防治疗方法治疗方法

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