摘要
目的：分析内蒙古中西部地区急性肝衰竭（ALF）的病因、临床特征、治疗措施及转归,为ALF的诊断及治疗提供参考.方法：回顾性分析内蒙古医科大学附属医院2006年6月-2012年5月住院治疗的32例ALF患者的临床资料.结果：患者主要发病年龄为21～52岁（81.25%）,男性19例,女性13例,男性高发于女性.药物性肝衰竭为主要病因,占h46.9%（15/32例）,其中以蒙药及中药所致多见,占药物性肝衰竭的80.00%（12/15例）.肝炎病毒感染所致ALF8例（占25.0%）;酒精性肝衰竭3例;妊娠急性脂肪肝2例;病因未明4例.临床治愈和好转4例（12.5%）,死亡28例（87.5%）,出现ALF至死亡时间为2～13态d.27例（86.7%）凝血酶原时间〉30 s,29例（91.2%）凝血酶原活动度〈20%;ALF患者前3位并发症是肝性脑病、感染及脑水肿.结论：内蒙古中西部地区以蒙药和中药所致的药物性肝衰竭为ALF的首要病因.医生选用药物治疗时要充分考虑药物毒不良反应,特别是肝脏毒性,减少药物所致ALF的发病;关注PT和PTA严重异常,及时发现肝衰竭.
Objective：To analyze the causes, clinical features, therapeutic measures and outcomes of acute liver failure （ALF） in patients in the midwestern Inner Mongolia. Methods：Clinical data of 32 patients with ALF, who were inhabitants of midwestern of Inner Mongolia, admitted to the Affiliated Hospital of Inner Mongolia Medical University from June 2006 to May 2012, were retrospectively analyzed. Results： The age of the patients was most prevalent between 21 to 52 years old（26 cases,81.25%）,and the number of male （19 cases） was higher than that of the female （13 cases）. Druginduced liver failure was the main cause of ALF（ 15 cases, 46. 9%）, and the case of Mongolian and Chinese traditional medicine was the main cause （12/15 cases, 80.0%）. Among 32 patients with ALF, hepatitis B virus infection accounted for 8 （25.0%）, 3 were alcoholic liver failure, 2 were due to acute fatty liver during pregnancy. The cause was unknown in 4 cases. After the treatment, 4 patients （12. 5%） recovered and 28 （87.5%） died. The duration between the onset of ALF to death was 2 - 13 days. Prothrombin time was longer than 30 seconds in 27 cases （86.7%）, and prothrombin activity was less than 20 seconds in 29 cases （91.2%）. The main complications of ALF were hepatic encephalopathy, infection, and brain edema. Conclusions：The main cause of ALF in the midwestern Inner Mongolia is drug, especially Mongolian and Traditional Chinese medicin. To reduce the incidence of ALF induced by drugs, their side effects should be seriously considered to avoid their toxicity to the liver. Significant changes in prothrombin time and prothrombin activi- ty should be taken as warning in order to diagnose ALF timely.
出处
《感染．炎症．修复》
2013年第4期235-238,共4页
Infection Inflammation Repair
关键词
肝功能衰竭
急性
临床特征
预后
Liver failure acute Clinical features Prognosis
