急性-慢性肝衰竭:从定义到管理
Abdurrahman Kadayifci1, Sidart Pradeep2, Eugenia Tsai3
1Division of Gastroenterology, UT Health San Antonio, San Antonio, TX, USA.
Annals of palliative medicine
|January 21, 2026
概括
急性至慢性肝衰竭 (ACLF) 是一种严重的疾病,死亡率高. 早期识别,干预和肝移植对于改善ACLF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.
- 关键护理医学 关键护理医学
- 免疫学 免疫学 免疫学
背景情况:
- 急性至慢性肝衰竭 (ACLF) 是一种严重的疾病,其特征是慢性肝病 (CLD) 的快速恶化,导致多器官功能障碍和高短期死亡率.
- 虽然ACLF的定义并未得到普遍认可,但其临床表现在全球范围内得到认可,其潜在原因和发病率因地区而异.
- 常见的ACLF触发因素包括细菌感染,与酒精有关的肝炎,病毒性肝炎爆发以及药物诱导的肝损伤.
研究的目的:
- 审查ACLF的定义,预后和临床过程.
- 强调早期识别和及时干预在管理ACLF的关键重要性.
- 突出目前的治疗策略和肝移植和息治疗的作用.
主要方法:
- 本综述通过全面的文献搜索,综合了关于ACLF的当前知识.
- 对诊断标准,流行病学变异和病理生理机制的现有数据的分析.
- 评估治疗方案,包括支持性护理,新兴疗法,肝移植和息护理.
主要成果:
- ACLF的病理生理学涉及免疫失调和循环崩,导致器官衰竭 (OF),死亡率与OF数量成比例增加.
- 目前的治疗策略主要是支持性,没有疾病修饰疗法被证明对长期存活有效.
- 肝移植 (LT) 为选定的ACLF患者提供了唯一的治愈选择,需要早期评估.
结论:
- 早期识别和及时管理对于改善ACLF患者的治疗结果至关重要.
- 综合护理包括息治疗 (PC) 和及时移植评估是必不可少的,因为高死亡风险.
- 需要进一步研究有效的疾病修饰疗法,以及优化支持性护理和移植协议.
更多相关视频
16:19Heterotopic Auxiliary Rat Liver Transplantation With Flow-regulated Portal Vein Arterialization in Acute Hepatic Failure
Published on: September 13, 2014
13.2K
09:44Generation of a Rat Model of Acute Liver Failure by Combining 70% Partial Hepatectomy and Acetaminophen
Published on: November 27, 2019
11.0K
相关概念视频
Acute Respiratory Failure-I
901
Acute respiratory failure is a condition characterized by the inability of the lungs to perform their primary function: gas exchange. This failure leads to insufficient oxygen levels (hypoxemia) in the blood, elevated carbon dioxide levels (hypercapnia), or both, causing critical impairment in organ function.
Definition: It is defined by specific criteria based on blood gas measurements. Hypoxemia happens when the partial pressure of oxygen (PaO2) falls below 60 mmHg. At the same time,...
Definition: It is defined by specific criteria based on blood gas measurements. Hypoxemia happens when the partial pressure of oxygen (PaO2) falls below 60 mmHg. At the same time,...
901
Acute Respiratory Failure-II
1.0K
Type I Respiratory Failure, or hypoxemic respiratory failure, occurs when the partial pressure of oxygen (PaO2) in arterial blood falls below 60 mmHg while breathing room air without a corresponding increase in arterial carbon dioxide levels (PaCO2). This condition highlights a significant impairment in the lungs' capacity to oxygenate the blood.
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
1.0K
Acute Respiratory Failure-V
476
The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Ensure that patients are monitored continuously for their response to therapy, including changes in...
476
Acute Respiratory Failure-III
811
Hypercapnic respiratory failure, also known as Type 2 or ventilatory respiratory failure, is a severe condition characterized by the body's inability to effectively remove carbon dioxide (CO2) from the bloodstream. It leads to an arterial CO2 pressure (PaCO2) exceeding 45 mmHg and a blood pH above 7.35. This situation indicates that the body's ventilatory demand, or the ventilation needed to maintain normal PaCO2 levels, surpasses its supply or the maximum gas flow achievable without...
811
Heart Failure V: Medical Management
227
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
227
Acute Respiratory Failure-IV
526
Respiratory failure can manifest suddenly or gradually, characterized by a rapid decline in PaO2 and a rapid rise in PaCO2. This situation indicates a severe respiratory problem that may quickly become a life-threatening emergency. One of the early signs of hypoxemic Acute Respiratory Failure (ARF) is a change in mental status due to the brain's sensitivity to oxygen levels and changes in acid-base balance. Symptoms such as restlessness, confusion, and agitation suggest inadequate oxygen...
526
