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单通道白蛋白透析（SPAD）作为一种在资源匮乏地区的治疗性体外肝脏支持：病例报告与文献综述

Single-Pass Albumin Dialysis (SPAD) as a Therapeutic Extracorporeal Liver Support in a Low-Resource Setting: Case Report and Literature Review.

作者信息

Roman Hernández David, Valdez-Gaona Alicia, García-Velasco Luis Arturo, Lemus Jordana S, González Herrera Omar, Cardenas Membrila Guillermo

机构信息

Intensive Care Unit, Hospital General "Dr. Manuel Gea Gonzalez", Mexico City, MEX.

Intensive Care Unit, Hospital General "Dr. Manuel Gea González", Mexico City, MEX.

出版信息

Cureus. 2025 Jun 11;17(6):e85782. doi: 10.7759/cureus.85782. eCollection 2025 Jun.

DOI:10.7759/cureus.85782
PMID:40656314
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12249485/
Abstract

Acute liver failure, a condition marked by high mortality, leads to a loss of liver function that impairs the detoxification of substances such as bilirubin, ammonia, and lactate, as well as the liver's synthetic functions, causing damage to other organs. New extracorporeal therapies, including single-pass albumin dialysis (SPAD), have been developed to support liver function. We present a case of a 25-year-old male with no significant past medical history who presented with multiple organ failure and acute kidney injury that required continuous renal replacement therapy (CRRT) with continuous venovenous hemodiafiltration (CVVHDF), necessitating SPAD for the treatment of the liver failure.

摘要

急性肝衰竭是一种死亡率很高的疾病，会导致肝功能丧失，损害胆红素、氨和乳酸等物质的解毒功能以及肝脏的合成功能，进而对其他器官造成损害。包括单通道白蛋白透析（SPAD）在内的新型体外治疗方法已被开发出来以支持肝功能。我们报告一例25岁男性病例，该患者既往无重大病史，出现多器官功能衰竭和急性肾损伤，需要采用持续静脉-静脉血液透析滤过（CVVHDF）进行持续肾脏替代治疗（CRRT），因此需要进行SPAD治疗肝衰竭。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9871/12249485/4e88369cddbf/cureus-0017-00000085782-i09.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9871/12249485/d4be39591334/cureus-0017-00000085782-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9871/12249485/d2c75c6482c0/cureus-0017-00000085782-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9871/12249485/c22d0f01ea61/cureus-0017-00000085782-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9871/12249485/ac913ffef176/cureus-0017-00000085782-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9871/12249485/93ad598ae68e/cureus-0017-00000085782-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9871/12249485/a2be86cd26ce/cureus-0017-00000085782-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9871/12249485/41dd5c9bf06a/cureus-0017-00000085782-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9871/12249485/4e061289696d/cureus-0017-00000085782-i08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9871/12249485/4e88369cddbf/cureus-0017-00000085782-i09.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9871/12249485/d4be39591334/cureus-0017-00000085782-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9871/12249485/d2c75c6482c0/cureus-0017-00000085782-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9871/12249485/c22d0f01ea61/cureus-0017-00000085782-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9871/12249485/ac913ffef176/cureus-0017-00000085782-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9871/12249485/93ad598ae68e/cureus-0017-00000085782-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9871/12249485/a2be86cd26ce/cureus-0017-00000085782-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9871/12249485/41dd5c9bf06a/cureus-0017-00000085782-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9871/12249485/4e061289696d/cureus-0017-00000085782-i08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9871/12249485/4e88369cddbf/cureus-0017-00000085782-i09.jpg

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本文引用的文献

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Prz Gastroenterol. 2024;19(2):101-111. doi: 10.5114/pg.2024.139297. Epub 2024 Apr 29.
2
Extended online hemodiafiltration associated with single-pass albumin dialysis, a feasible alternative for patients with hepatorenal insufficiency.延长在线血液透析滤过联合单次通过白蛋白透析，是肝肾不全患者的一种可行替代方案。
Nefrologia (Engl Ed). 2023 Nov-Dec;43(6):801-803. doi: 10.1016/j.nefroe.2024.01.003. Epub 2024 Jan 10.
3
Extracorporeal albumin dialysis in critically ill patients with liver failure: Comparison of four different devices-A retrospective analysis.体外白蛋白透析治疗肝功能衰竭危重症患者：四种不同设备的比较-回顾性分析。
Int J Artif Organs. 2023 Sep;46(8-9):481-491. doi: 10.1177/03913988231191952. Epub 2023 Aug 23.
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Critical care hepatology: definitions, incidence, prognosis and role of liver failure in critically ill patients.危重病肝科学：定义、发生率、预后以及肝衰竭在危重病患者中的作用。
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