凝血因子及颅内压监测在中暑所致急性肝衰竭中的诊断价值：病例报告及文献复习
Diagnostic value of coagulation factor and intracranial pressure monitoring in acute liver failure from heat stroke: case report and review of the literature.
作者信息
Ramanathan M, Pedersen M, Ramsey R, Seetharam A
机构信息
Department of Internal Medicine, Banner Good Samaritan Medical Center, Phoenix, Arizona.
Department of Internal Medicine, Banner Good Samaritan Medical Center, Phoenix, Arizona.
出版信息
Transplant Proc. 2015 Apr;47(3):817-9. doi: 10.1016/j.transproceed.2015.02.007.
BACKGROUND
Exertional heat stroke (HS) with resultant acute liver failure (ALF) is a rare condition with high mortality. Diagnosis of ALF in the context of HS is confounded by numerous laboratory abnormalities related to multisystem organ dysfunction.
CASE REPORT
We present the case of a 20-year-old male athlete with exertional HS who developed ALF and was treated successfully with orthotopic liver transplantation. He remained well after 1 year with normal liver function and no permanent neurologic impairment. Diagnosis and treatment was guided by serial monitoring of coagulation factors and intracranial pressure (ICP).
CONCLUSIONS
Currently, there are no well validated prognostic tools that predict the need for or survival with orthotopic liver transplantation for HS. We propose that serial monitoring of coagulation factors and, when safe and feasible, ICP monitoring may help to guide clinical decision making in this context.
背景
劳力性热射病（HS）伴发急性肝衰竭（ALF）是一种罕见疾病，死亡率高。HS 背景下的 ALF 诊断因与多系统器官功能障碍相关的众多实验室异常而变得复杂。
病例报告
我们报告了一名 20 岁男性运动员的病例，该运动员患有劳力性 HS，并发 ALF，并通过原位肝移植成功治疗。1 年后他情况良好，肝功能正常，无永久性神经功能损害。诊断和治疗通过连续监测凝血因子和颅内压（ICP）来指导。
结论
目前，尚无经过充分验证的预后工具可预测 HS 原位肝移植的需求或生存情况。我们建议，连续监测凝血因子，并在安全可行时进行 ICP 监测，可能有助于在此背景下指导临床决策。
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