中国实用儿科杂志

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儿童暴发性肝衰竭人工肝治疗

祝益民刘萍萍   

  1. 作者单位:湖南省人民医院儿科医学中心,湖南 长沙 410000
  • 出版日期:2014-03-06 发布日期:2014-03-11

Artificial liver support for fulminant hepatic failure in children.       

ZHU Yi-min, LIU Ping-ping   

  1. Pediatrics Medical Centre, Hunan Provincial People's Hospital, Changsha,410000,Hunan,China.
  • Online:2014-03-06 Published:2014-03-11

摘要:

儿童暴发性肝衰竭的发病率还不明确,发生虽然少见,但短期内可以导致患儿因肝性脑病、弥散性血管内凝血(DIC)、多脏器衰竭等原因死亡。肝移植是其主要治疗方法,但长期肝源缺乏却限制了这一有效治疗。本文在介绍儿童暴发性肝衰竭的现状基础上,重点对人工肝技术的应用的效果评价进行探讨,认为人工肝对儿童暴发性肝衰竭治疗的作用举足轻重。根据人工肝的分类,主要讨论非生物型人工肝分子吸附循环系统(MARS)的应用,包括人工肝适应证和各种方法的优点和缺点。目前,人工肝治疗也面临许多问题,人工肝支持系统对患儿的治疗评估和研究尚不足,在改善生存方面尚未形成一致共识。

关键词: 暴发性肝衰竭, 儿童, 人工肝, 分子吸附循环系统

Abstract:

 The true incidence of fulminant hepatic failure in the pediatric population is unknown, though fulminant hepatic failure is a rare but devastating syndrome(such as hepatic encephalopathy,DIC,MODS) that results in the death of most children affected. The mainstay of the treatment is liver transplantation,however, organ shortage limits its use.The purpose of this review is to introduce the current situation of fulminant liver failure in children,focusing on assessing the application of artificial liver,which is considered to  play a pivotal role in the treatment of fulminant liver failure.According to its classification,we mainly discussed the application of non-biological artificial liver, including its indications,advantages and disadvantages,especially the MARS. At present, the artificial liver treatment also faces many problems. None of the ELS techniques has yet been evaluated systematically in children,and survival benefits have not yet been demonstrated.

Key words: fulminant hepatic failure, children, artificial liver support, MARS

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