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一例慢性肝功能衰竭急性发作的肝硬化患者多次急性失代偿事件的成功药物治疗:病例报告

Successful Pharmacotherapy for Multiple Acute Decompensation Events in a Cirrhotic Patient with Acute-on-chronic Liver Failure: A Case Report.

作者信息

Xu Xiangbo, Bai Zhaohui, Zhao Qingchun, Li Hongyu, Shi Qiang, Deng Jiao, Zhang Jingqiao, Guo Xiaozhong, Qi Xingshun

机构信息

Department of Gastroenterology, General Hospital of Shenyang Military Area, Shenyang 110840, Liaoning Province, China.

Postgraduate College, Shenyang Pharmaceutical University, Shenyang 110016, Liaoning Province, China.

出版信息

J Transl Int Med. 2018 Dec 31;6(4):189-193. doi: 10.2478/jtim-2018-0035. eCollection 2018 Dec.

DOI:10.2478/jtim-2018-0035
PMID:30637207
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6326027/
Abstract

Acute-on-chronic liver failure (ACLF) is a potentially lethal syndrome, which is characterized by an acute deterioration of liver function in patients with chronic liver diseases. The present paper reported that an alcoholic cirrhotic patient with ACLF developed septic shock, hydrothorax, ascites, hepatic encephalopathy, acute kidney injury, and acute upper gastrointestinal bleeding at the same hospitalization and was successfully rescued by pharmacotherapy alone without any invasive intervention.

摘要

慢加急性肝衰竭(ACLF)是一种潜在的致命综合征,其特征为慢性肝病患者的肝功能急性恶化。本文报道了一名患有ACLF的酒精性肝硬化患者在同一住院期间发生了感染性休克、胸腔积液、腹水、肝性脑病、急性肾损伤和急性上消化道出血,仅通过药物治疗就成功获救,未进行任何侵入性干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae45/6326027/7bb76a9a01ee/jtim-06-189-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae45/6326027/7bb76a9a01ee/jtim-06-189-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae45/6326027/7bb76a9a01ee/jtim-06-189-g001.jpg

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本文引用的文献

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Acute-on-chronic liver failure: recent update.慢加急性肝衰竭:近期进展
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2
Child-Pugh, MELD, and ALBI scores for predicting the in-hospital mortality in cirrhotic patients with acute-on-chronic liver failure.用于预测慢性肝衰竭急性发作的肝硬化患者院内死亡率的Child-Pugh、MELD和ALBI评分。
Expert Rev Gastroenterol Hepatol. 2016 Aug;10(8):971-80. doi: 10.1080/17474124.2016.1177788. Epub 2016 Apr 25.
3
Child-Pugh Versus MELD Score for the Assessment of Prognosis in Liver Cirrhosis: A Systematic Review and Meta-Analysis of Observational Studies.
用于评估肝硬化预后的Child-Pugh评分与终末期肝病模型(MELD)评分:观察性研究的系统评价和荟萃分析
Medicine (Baltimore). 2016 Feb;95(8):e2877. doi: 10.1097/MD.0000000000002877.
4
The clinical management of abdominal ascites, spontaneous bacterial peritonitis and hepatorenal syndrome: a review of current guidelines and recommendations.腹水性腹水、自发性细菌性腹膜炎和肝肾综合征的临床管理:当前指南与建议综述
Eur J Gastroenterol Hepatol. 2016 Mar;28(3):e10-8. doi: 10.1097/MEG.0000000000000548.
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Terlipressin given by continuous intravenous infusion versus intravenous boluses in the treatment of hepatorenal syndrome: A randomized controlled study.特利加压素持续静脉输注与静脉推注治疗肝肾综合征的随机对照研究。
Hepatology. 2016 Mar;63(3):983-92. doi: 10.1002/hep.28396. Epub 2016 Feb 3.
6
Acute-on-chronic liver failure: Pathogenesis, prognostic factors and management.急性-on-慢性肝衰竭:发病机制、预后因素及管理。 注:原文中“Acute-on-chronic”表述不太准确,可能是“acute-on-chronic”,准确意思是“慢加急性”。完整准确译文应该是:慢加急性肝衰竭:发病机制、预后因素及管理。
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Septic Shock: Advances in Diagnosis and Treatment.脓毒性休克:诊断与治疗进展
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Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific Association for the Study of the Liver (APASL) 2014.《急性-on-慢性肝衰竭:亚太肝脏研究协会(APASL)2014年共识推荐》
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