Liver failure is severe liver injury caused by various factors. This article summarizes currently used therapeutic methods for liver failure,and the universally acknowledged therapeutic methods include intensive care and supportive care,etiological treatment,regulation of immune function,prevention and treatment of various complications,supportive treatment with artificial liver,and liver transplantation. It is pointed out that the treatment of liver failure should focus on the multimodality therapy of internal medicine- artificial liver- liver transplantation,and that early diagnosis and treatment should be emphasized in clinical practice. The multimodality therapy should be developed according to the etiology,and complications should be actively prevented and treated. A multidisciplinary team should be established to develop individualized diagnosis and treatment regiments,so as to reduce the mortality rate and improve patients' clinical outcome.
[1]Chinese Society of Hepatology and Chinese Society of Infectious Diseases,Chinese Medical Association.The guideline of prevention and treatment for chronic hepatitis B:a 2015 update[J].J Clin Hepatol,2015,31(12):1941-1960.(in Chinese)中华医学会肝病学分会,中华医学会感染病学分会.慢性乙型肝炎防治指南(2015年更新版)[J].临床肝胆病杂志,2015,31(12):1941-1960.
|
[2]Drug-induced Liver Disease Study Group,Chinese Society of Hepatology,Chinese Medical Association.Guidelines for the management of drug-induced liver injury[J].J Clin Hepatol,2015,31(11):1752-1769.(in Chinese)中华医学会肝病学分会药物性肝病学组.药物性肝损伤诊治指南[J].临床肝胆病杂志,2015,31(11):1752-1769.
|
[3]HAN T,LIU Y,LIU H,et al.Serum thymosin beta4 levels in patients with hepatitis B virus-related liver failure[J].World J Gastroenterol,2010,16(5):625-630.
|
[4]LI Z,SU SP,SUN JM.Safety and efficacy of thymosinα1 treatment of patients with chronic severe hepatitis B[J].China Prac Med,2013,8(14):63-64.(in Chinese)李峥,苏双萍,孙家敏.胸腺肽α1治疗慢性乙型重型肝炎的临床疗效观察[J].中国实用医药,2013,8(14):63-64.
|
[5]CHAVEZ-TAPIA NC,MENDIOLA-PASTRANA I,ORNELASARROYO VJ,et al.Granulocyte-colony stimulating factor for acuteon-chronic liver failure:systematic review and meta-analysis[J].Ann Hepatol,2015,14(5):631-641.
|
[6]SPAHR L,LAMBERT JF,RUBBIA-BRANDT L,et al.Granulocyte-colony stimulating factor induces proliferation of hepatic progenitors in alcoholic steatohepatitis:a randomized trial[J].Hepatology,2008,48(1):221-229.
|
[7]SINGH V,SHARMA AK,NARASIMHAN RL,et al.Granulocyte colony-stimulating factor in severe alcoholic hepatitis:a randomized pilot study[J].Am J Gastroenterol,2014,109(9):1417-1423.
|
[8]GARG V,GARG HK,KHAN A,et al.Granulocyte-colony stimulating factor mobilizes CD34+cells and improves survival of patients with acute-on-chronic liver failure[J].Gastroenterology,2012,142(3):505-512.
|
[9]DUAN XZ,LIU FF,TONG JJ,et al.Granulocyte-colony stimulating factor therapy improves survival in patients with hepatitis B virus-associated acute-on-chronic liver failure[J].World J Gastroenterol,2013,19(7):1104-1110.
|
[10]SINGH T,GUPTA N,ALKHOURI N,et al.A guide to managing acute liver failure[J].Cleve Clin J Med,2016,83(6):453-462.
|
[11]BAJAJ JS,RATLIFF SM,HEUMAN DM,et al.Proton pump inhibitors are associated with a high rate of serious infections in veterans with decompensated cirrhosis[J].Aliment Pharmacol Ther,2012,36(9):866-874.
|
[12]AMODIO P,BEMEUR C,BUTTERWORTH R,et al.The nutritional management of hepatic encephalopathy in patients with cirrhosis:International Society for Hepatic Encephalopathy and Nitrogen Metabolism Consensus[J].Hepatology,2013,58(1):325-336.
|
[13]Chinese Society of Gastroenterology,Chinese Medical Association;Chinese Society of Hepatology,Chinese Medical Association.Consensus statement on the diagnosis and treatment of hepatic encephalopathy in China(2013,Chongqing)[J/CD].Chin J Front Med Sci:Electronic Version,2014,6(2):81-93.(in Chinese)中华医学会消化病学分会,中华医学会肝病学分会.中国肝性脑病诊治共识意见(2013年,重庆)[J/CD].中国医学前沿杂志:电子版,2014,6(2):81-93.
|
[14]VILSTRUP H,AMODIO P,BAJAJ J,et al.Hepatic encephalopathy in chronic liver disease:2014 Practice Guideline by the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver[J].Hepatology,2014,60(2):715-735.
|
[15]EGEROD ISRAELSEN M,GLUUD LL,BENDTSEN F,et al.Hepatorenal syndrome:diagnosis,treatment and prevention[J].Ugeskr Laeger,2013,175(22):1562-1566.
|
[16]PIANO S,MORANDO F,FASOLATO S,et al.Continuous recurrence of type 1 hepatorenal syndrome and long-term treatment with terlipressin and albumin:a new exception to MELD score in the allocation system to liver transplantation?[J].J Hepatol,2011,55(2):491-496.
|
[17]GLUUD LL,CHRISTENSEN K,CHRISTENSEN E,et al.Terlipressin for hepatorenal syndrome[J].Cochrane Database Syst Rev,2012,12(9):CD005162.
|
[18]ZHANG Y,NIE QH.Analysis of complications and death causes of1892 patients with liver failure[J].J Pract Hepatol,2014,17(2):129-132.(in Chinese)张野,聂青和.1892例肝衰竭患者并发症及死亡原因分析[J].实用肝脏病杂志,2014,17(2):129-132.
|
[19]LI L,NING GX,SUN MH,et al.Effects of multi disciplinary team management model on the short-term prognosis of patients with liver failure[J].Chin J Med Guide,2016,18(2):211-212.(in Chinese)李力,宁更献,孙梅花,等.多学科团队管理模式对肝功能衰竭患者近期预后的影响[J].中国医药导刊,2016,18(2):211-212.
|
[20]CHEN JJ,HUANG JR,YANG Q,et al.Plasma exchange-centered artificial liver support system in hepatitis B virus-related acute-on-chronic liver failure:a nationwide prospective multicenter study in China[J].Hepatobiliary Pancreat Dis Int,2016,15(3):275-281.
|
[21]SCHILSKY ML.Acute liver failure and liver assist devices[J].Transplant Proc,2011,43(3):879-883.
|
[22]NYBERG SL.Bridging the gap:advances in artificial liver support[J].Liver Transpl,2012,18(Suppl 2):s10-s14.
|
[23]XU X,LIU X,LING Q,et al.Artificial liver support system combined with liver transplantation in the treatment of patients with acute-onchronic liver failure[J].PLoS One,2013,8(3):e58738.
|
[24] Liver Failure and Artificial Liver Group,Guideline for non-bioartificial liver support systems in treatment of liver failure:2016 update[J].Chin J Clin Infect Dis,2016,9(2):97-103.(in Chinese)中华医学会感染病学分会肝衰竭与人工肝学组.非生物型人工肝治疗肝衰竭指南(2016)[J].中华临床感染病杂志,2016,9(2):97-103.
|
[25]LI J,ZHANG L,XIN J,et al.Immediate intraportal transplantation of human bone marrow mesenchymal stem cells prevents death from fulminant hepatic failure in pigs[J].Hepatology,2012,56(3):1044-1052.
|
[26]STARZL TE.The long reach of liver transplantation[J].Nat Med,2012,18(10):1489-1492.
|
[27]ZHENG SS,YU J,ZHANG W.Current development of liver transplantation in China[J].J Clin Hepatol,2014,30(1):2-4.(in Chinese)郑树森,俞军,张武.肝移植在中国的发展现状[J].临床肝胆病杂志,2014,30(1):2-4.
|