对乙酰氨基酚过量后的肝移植
Liver transplantation after paracetamol overdose.
作者信息
O'Grady J G, Wendon J, Tan K C, Potter D, Cottam S, Cohen A T, Gimson A E, Williams R
机构信息
Institute of Liver Studies, King's College School of Medicine and Dentistry, London.
出版信息
BMJ. 1991 Jul 27;303(6796):221-3. doi: 10.1136/bmj.303.6796.221.
OBJECTIVE
To evaluate the role of liver transplantation after paracetamol overdose.
DESIGN
Prospective study of consecutive candidates for transplantation and performance of transplantation over 18 months.
SETTING
Liver unit, King's College Hospital, London.
MAIN OUTCOME MEASURES
Fulfilment of indicators of poor prognosis, selection for transplantation, transplantation, survival.
RESULTS
30 of 37 patients considered to have a reasonable prognosis with intensive medical care survived. Of 14 of 29 patients considered to have a very poor prognosis and registered for urgent liver transplantation, six received liver transplants, four of whom survived, while seven died and one survived without a transplant. Three of 15 patients with poor prognostic indicators but not selected for transplantation survived.
CONCLUSION
Liver transplantation will have a definite but limited role in the management of fulminant hepatic failure induced by paracetamol.
目的
评估对乙酰氨基酚过量后肝移植的作用。
设计
对连续的移植候选者进行前瞻性研究，并在18个月内进行移植手术。
地点
伦敦国王学院医院肝病科。
主要观察指标
预后不良指标的达成情况、移植的选择、移植手术、生存率。
结果
37例经强化医疗护理被认为预后合理的患者中有30例存活。29例被认为预后极差并登记进行紧急肝移植的患者中，14例接受了肝移植，其中4例存活，7例死亡，1例未接受移植而存活。15例有不良预后指标但未被选择进行移植的患者中有3例存活。
结论
肝移植在对乙酰氨基酚所致暴发性肝衰竭的治疗中将发挥明确但有限的作用。
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