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[急性肝衰竭]

[Acute liver failure].

作者信息

Koch A, Trautwein C

机构信息

Medizinische Klinik III, Universitätsklinikum Aachen, Pauwelsstr. 30, 52072 Aachen, Deutschland.

出版信息

Intensivmed Notfallmed. 2010;47(4):235-242. doi: 10.1007/s00390-009-0153-x. Epub 2010 Apr 23.

Abstract

Acute liver failure (ALF) is characterized by loss of liver function without pre-existing chronic liver disease. Drug toxicity and viral hepatitis have been identified as the main causes of ALF in Germany. The regeneration capability of the liver and overall prognosis are determined by the underlying etiology. Advances in intensive care medicine, supportive therapy, and transplantation surgery have improved the overall outcome of ALF over the last two decades. The clinical syndrome of ALF is mainly due to a release of inflammatory cytokines from necrotic hepatocytes, which lead to disastrous consequences in the immune system and hemodynamics. The main goals of supportive intensive care therapy in ALF are early identification and treatment of infections and the prevention and therapy of cerebral hypertension.

摘要

急性肝衰竭(ALF)的特征是在无既往慢性肝病的情况下肝功能丧失。在德国,药物毒性和病毒性肝炎已被确定为ALF的主要病因。肝脏的再生能力和总体预后由潜在病因决定。在过去二十年中,重症监护医学、支持性治疗和移植手术的进展改善了ALF的总体结局。ALF的临床综合征主要是由于坏死肝细胞释放炎性细胞因子,这会在免疫系统和血流动力学方面导致灾难性后果。ALF支持性重症监护治疗的主要目标是早期识别和治疗感染以及预防和治疗脑水肿。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f61f/7101637/10f4bfd74e8b/390_2009_153_Fig1_HTML.jpg

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