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[急诊与重症医学中急性失代偿期肝硬化的管理]

[Management of acutely decompensated liver cirrhosis in emergency and critical care medicine].

作者信息

Kasper Philipp, Tacke Frank, Michels Guido

机构信息

Medizinische Fakultät und Uniklinik Köln, Klinik für Gastroenterologie und Hepatologie, Universität zu Köln, Köln, Deutschland.

Medizinische Klinik mit Schwerpunkt Hepatologie und Gastroenterologie, Charité Campus Mitte und Campus Virchow-Klinikum, Charité Universitätsmedizin Berlin, Berlin, Deutschland.

出版信息

Anaesthesist. 2022 May;71(5):403-412. doi: 10.1007/s00101-022-01113-y. Epub 2022 Mar 31.

Abstract

Acute decompensation in patients with liver cirrhosis is characterized by the development of ascites, gastrointestinal bleeding, hepatic encephalopathy, or bacterial infection and is often accompanied by further extrahepatic organ dysfunction. Since critically ill patients with decompensated cirrhosis have a high mortality risk, rapid identification and treatment of the triggering event of decompensation (e.g., infection, hemorrhage, drugs) as well as specific measures for the treatment of concomitant extrahepatic organ dysfunctions are essential in order to improve the patient's prognosis and to prevent the development of acute-on-chronic liver failure (ACLF).

摘要

肝硬化患者的急性失代偿表现为腹水、胃肠道出血、肝性脑病或细菌感染的发生,且常伴有进一步的肝外器官功能障碍。由于失代偿期肝硬化的重症患者具有较高的死亡风险,因此快速识别和治疗失代偿的触发事件(如感染、出血、药物)以及治疗伴随的肝外器官功能障碍的具体措施对于改善患者预后及预防慢加急性肝衰竭(ACLF)的发生至关重要。

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