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由临床病例讨论肝肾综合征识别和防治难点

王吉耀

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由临床病例讨论肝肾综合征识别和防治难点

详细信息
  • 中图分类号: R575.3;R692.5

The difficulties in diagnosis and treatment of hepatorenal syndrome-raised by clinical cases

  • 摘要: 本文通过两个病例复习了肝肾综合征的国际腹水协会诊断标准和临床分型。认为诊断的难点在于要从临床、实验室和影像学排除由于肾前、肾性和肾后性因素引起的急性肾功能衰竭。还从这两个病例的治疗过程讨论如何根据肝肾综合征的发病机制和应用循证医学证据进行防治。

     

  • [1] Salerno F, Gerbes A, Gines P, et al. Diagnosis, prevention and treatment of the hepatorenal syndrome in cirrhosis: a consensus workshop of the international ascites club[J]. Gut, 2007, 56:1310-1318.
    [2]Martín-LlahíM, Guevara N, Torre L, et al.Prognostic im-portance of the cause of renal failure in patients with cirrhosis[J].Gastroenterology, 2011, 140 (2) :488-496.
    [3]Gines A, Escorsell A, Gines P, et al.Incidence, predictive fac-tors, and prognosis of hepatorenal syndrome in cirrhosis withascites[J].Gastroenterology, 1993, 105 (1) :229-236.
    [4] Garcia-Tsao G, Parikh CR, Viola A. Acute kidney injury in cirrhosis[J]. Hepatology, 2008, 48 (6) :2064-2077.
    [5]Arroya V, Bataller R, Guevara M.Treatment of hepatorenalsyndrome in cirrhosis[M].∥Arroya V, Gines P Rodes J, etal.Ascites and renal dysfunction in liver disease.BlackwellScience, 1999:492-510.
    [6]Gluud LL, Christensen K, Christensen E, et al.systematicreview of randomized trials on vasoconstrictor drugs for hep-atorenal syndrome[J].Hepatology, 2010, 51 (2) :576-584.
    [7]Sanyal AJ, Boyer T, Garcia-Tsao G, et al.A randomized, prospective, double-blind, placebo-controlled trial of terli-pressin for type 1 hepatorenal syndrome[J].Gastroenterolo-gy, 2008, 134 (5) :1360-1368.
    [8]Martin-Llahi M, Pepin MN, Guevara M, et al.Terlipressinand albumin vs albumin in patients with cirrhosis and hepator-enal syndrome:a randomized study[J].Gastroenterology, 2008, 134 (5) :1352-1359.
    [9]Wong F, Pantea L, Sniderman K.Midodrine, octreotide, albu-min, and TIPS in selected patients with cirrhosis and type 1hepatorenal syndrome[J].Hepatology, 2004, 40 (1) :55-64.
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  • 出版日期:  2011-10-20
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