Zipprich B, Nilius R, Otto L, Busse H J
Z Gesamte Inn Med. 1977 Jun 15;32(12):259-65.
The name of the disease coma hepaticum is a collective notion for etiologically, pathologo-anatomically and biochemically different kinds of a failure of the function of the liver. A demarcation of different forms of the liver coma is necessary above all for prognostic and therapeutic reasons: hepatic disintegration coma, coma in hepatic failure, mixed coma, false hepatic coma, ferment block coma. Despite certain progress the therapeutic possibilities in hepatic coma cannot satisfy in recent years. Also the use of different, partly very expensive methods of the so-called liver substitute (exchange function and plasmapheresis, heterologous and homologous extracorporal liver perfusion, parasymbiotic crossed circulation, haemoperfusion with encapsulated activated charcoal, liver transplantation) up to now did not lead to a decisive improvement of the nearly infaust prognosis of the hepatic disintegration coma. Therefore preventing measures and careful control of endangered patients deserve particular attention.
肝昏迷这一病名是对病因、病理解剖及生化方面不同类型肝功能衰竭的统称。出于预后和治疗的原因，首要的是区分肝昏迷的不同形式：肝解体昏迷、肝衰竭昏迷、混合性昏迷、假性肝昏迷、酶阻断昏迷。尽管近年来在治疗方面取得了一定进展，但肝昏迷的治疗手段仍不尽如人意。使用不同的、部分非常昂贵的所谓肝脏替代方法（交换功能与血浆置换、异体和同体体外肝脏灌注、共生交叉循环、用包囊活性炭进行血液灌流、肝移植），到目前为止，并未使肝解体昏迷几乎毫无希望的预后得到决定性改善。因此，预防措施以及对濒危患者的密切监测值得特别关注。
