Hadem J, Schneider A S, Manns M P
Klinik für Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover, Carl-Neuberg-Straße 1, 30625, Hannover.
Internist (Berl). 2011 Jul;52(7):804, 806-8, 810-4. doi: 10.1007/s00108-010-2793-0.
Acute liver failure is a multisystem disease with predominantly sudden and severe hepatic injury and hepatic encephalopathy caused by apoptotic or necrotic hepatocyte damage. The clinical challenge in patients with acute liver failure is to promptly identify those with poor prognosis and refer them for emergency liver transplantation. This review article highlights the main aspects of decision making in the setting of acute liver failure, summarizes new aspects of its critical care management and gives an overview of sclerosing cholangitis in the critically ill patient, an under-recognized disease entity that can progress to acute liver failure.
急性肝衰竭是一种多系统疾病，主要特征为肝细胞凋亡或坏死性损伤导致的突发严重肝损伤和肝性脑病。急性肝衰竭患者面临的临床挑战是迅速识别预后不良的患者，并将其转诊进行紧急肝移植。这篇综述文章重点介绍了急性肝衰竭情况下决策的主要方面，总结了其重症监护管理的新内容，并概述了危重症患者中一种未得到充分认识、可进展为急性肝衰竭的疾病——硬化性胆管炎。
