摘要
肝肾综合征（HRS）是肝衰竭、失代偿期肝硬化和肝癌晚期等重症肝病常见的严重并发症之一。 HRS 诊断标准虽已十分明确，但缺乏特异性诊断指标。 HRS 的诊断仍是一种临床排除性诊断，在实际工作中还是一个难题，因此需对 HRS 的早期表现提高警惕，无论是否达到 HRS 的诊断标准，一旦出现尿量突发显著减少伴血清肌酐水平升高，均提示 HRS 早期征象的发生，须及时诊断并给予及时的处理。在治疗方面，血管收缩剂联合白蛋白、TIPS、连续性肾脏替代治疗和 MARS 等在短暂改善肾功能的同时，主要为肝移植作准备。迄今为止，肝移植是 HRS 最有效的治疗方法。如不能及时接受肝移植，患者病死率达80%～100%。临床上“防重于治”。
Hepatorenal syndrome（HRS） is one of serious complications of severe liver diseases including liver failure, de-compensated cirrhosis and liver cancer. Although the diagnostic criteria for HRS has been defined clearly, the specific diagnostic indicators are lack in clinical practice. HRS is just a clinical exclusion diagnosis. Once the symptom of significant reduction in the amount of urine with increased serum creatinine levels suddenly appears,it might be the early signs of HRS. As respect to the treatment of HRS,combination of vasoconstrictors and albumin,TIPS,CRRT and MARS could improve renal function, mainly serving as a bridge for liver transplantation. So far,liver transplantation is the most effective treatment for HRS.
出处
《实用肝脏病杂志》
CAS
2014年第2期198-201,共4页
Journal of Practical Hepatology
