Latifi R, Killam R W, Dudrick S J
Hermann Hospital, Houston, Texas.
Surg Clin North Am. 1991 Jun;71(3):567-78. doi: 10.1016/s0039-6109(16)45434-4.
The most important manifestations of advanced liver disease are malnutrition, encephalopathy, and hepatorenal syndrome. Appropriate and optimal nutritional and metabolic support with specially formulated solutions enriched in branched-chain amino acids, together with other advanced treatments such as plasmapheresis, hemofiltration, and continuous arteriovenous hemodialysis, can correct the most important metabolic and clinical aberrations and temporarily improve the quality of life. However, the ultimately poor prognosis of patients with severe liver failure has not been altered significantly to date by the provision of nonspecific or specifically tailored nutrient regimens. The prognosis appears to depend on the arrest, correction, or reversal of the primary pathophysiologic process.
晚期肝病最重要的表现是营养不良、肝性脑病和肝肾综合征。使用富含支链氨基酸的特制溶液进行适当且优化的营养和代谢支持，再加上其他先进治疗方法，如血浆置换、血液滤过和持续动静脉血液透析，可以纠正最重要的代谢和临床异常，并暂时改善生活质量。然而，迄今为止，提供非特异性或专门定制的营养方案并未显著改变严重肝衰竭患者最终较差的预后。预后似乎取决于原发性病理生理过程的停止、纠正或逆转。
