Sherlock S, Parbhoo S P
Postgrad Med J. 1971 Jul;47(549):493-8. doi: 10.1136/pgmj.47.549.493.
Acute fulminant hepatitis leads to complex biochemical and circulatory disturbances including coma. These can be predicted to some extent by knowledge of the functions of the normal liver cells. Ineffective haemostasis, coma, hypoglycaemia, electrolyte abnormalities, hypotension and renal circulatory failure are particularly important. Management should be governed by the abnormalities found in the individual patient. Fluid overload and sedation must be avoided. More complex methods of temporary hepatic support such as exchange transfusion or perfusion of the isolated pig's liver should only be considered after simpler methods of correction have been attempted for a reasonable period of time and found wanting. The prognosis of acute hepatocellular failure reaching the stage of deep coma is very poor, the mortality being about 80-90%.
急性暴发性肝炎会导致包括昏迷在内的复杂生化和循环紊乱。通过了解正常肝细胞的功能，这些情况在一定程度上是可以预测的。止血无效、昏迷、低血糖、电解质异常、低血压和肾循环衰竭尤为重要。治疗应根据个体患者出现的异常情况进行。必须避免液体过载和镇静。只有在尝试了更简单的纠正方法并在合理时间内发现效果不佳之后，才应考虑更复杂的临时肝脏支持方法，如换血或灌注离体猪肝。急性肝细胞衰竭发展到深度昏迷阶段的预后非常差，死亡率约为80%至90%。
