Division of Gastroenterology and Hepatology, Department of Medicine, Rajavithi Hospital, College of Medicine, Rangsit University, Rajavithi Road, Ratchathewi, Bangkok 10400, Thailand; Division of Gastroenterology and Hepatology, Department of Medicine, Hospital of the University of Pennsylvania, University of Pennsylvania, 2 Dulles, 3400 Spruce Street, Philadelphia, PA 19104, USA.
Division of Gastroenterology and Hepatology, Department of Medicine, Hospital of the University of Pennsylvania, University of Pennsylvania, 2 Dulles, 3400 Spruce Street, Philadelphia, PA 19104, USA.
Clin Liver Dis. 2017 Nov;21(4):769-792. doi: 10.1016/j.cld.2017.06.002. Epub 2017 Jul 29.
Acute liver failure (ALF) is a life-threatening condition of heterogeneous etiology. Outcomes are better with early recognition and prompt initiation of etiology-specific therapy, intensive care protocols, and liver transplantation (LT). Prognostic scoring systems include the King's College Criteria and Model for End-stage Liver Disease score. Cerebral edema and intracranial hypertension are reasons for high morbidity and mortality; hypertonic saline is suggested for patients with a high risk for developing intracranial hypertension, and when it does, mannitol is recommended as first-line therapy. Extracorporeal liver support system may serve as a bridge to LT and may increase LT-free survival in select cases.
急性肝衰竭（ALF）是一种危及生命的异质性病因疾病。早期识别和及时启动病因特异性治疗、重症监护方案和肝移植（LT）可以改善预后。预后评分系统包括 King's 学院标准和终末期肝病模型评分。脑水肿和颅内高压是高发病率和死亡率的原因；高渗盐水建议用于有颅内高压风险的患者，当发生颅内高压时，甘露醇被推荐作为一线治疗药物。体外肝支持系统可以作为 LT 的桥梁，并可在某些情况下增加 LT 无生存获益。
