Ambühl P M, Ballmer P E, Krähenbühl S
Klinik B für Innere Medizin, Kantonsspital, St. Gallen.
Schweiz Med Wochenschr. 1994 Mar 5;124(9):368-80.
Fulminant hepatic failure may develop as a complication of liver disease of various etiology. Infectious agents, drugs and liver toxins represent the major causes of fulminant hepatitis. The function of many organ systems may be impaired during acute hepatic failure because of the crucial role of the liver in intermediary metabolism. The mortality of 50% or more is mainly due to cerebral edema, bleeding from the gastrointestinal tract or disseminated infections. In this review the causes, complications and pathophysiology of fulminant hepatitis are discussed, with particular reference to the prevention of complications and to therapeutic strategies. Moreover, criteria for assessment of prognosis are discussed. A case report illustrates the complex clinical picture and frequently fatal outcome of the disease.
暴发性肝衰竭可能作为各种病因所致肝脏疾病的一种并发症而发生。感染原、药物和肝毒素是暴发性肝炎的主要病因。由于肝脏在中间代谢中起关键作用，在急性肝衰竭期间许多器官系统的功能可能受损。50%或更高的死亡率主要归因于脑水肿、胃肠道出血或播散性感染。在这篇综述中，将讨论暴发性肝炎的病因、并发症和病理生理学，尤其涉及并发症的预防和治疗策略。此外，还将讨论预后评估标准。一则病例报告说明了该病复杂的临床表现和往往致命的结局。
