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1、肝衰竭的治疗XXX市人民医院支持治疗1病因治疗2并发症治疗4其他治疗3CONTENTS目录一、支持治疗Bedrest,reducingenergyconsumption,andalleviating(缓解)theburdenoftheliver(Ⅲ);MonitoringPTA/INR,bloodammonia(血氨)andbloodbiochemicalindices,analyzingarterialbloodlactate（乳酸）,endotoxin（内毒素）,hepadnavirusmarkers（嗜肝DNA病毒）,ceruloplasmin（铜兰
2、蛋白）,antibodiesofautoimmuneliverdiseases（自免肝抗体）,andexaminingabdomenbyB-ultrasound(liver,gallbladder,spleenandpancreas,ascites),takingchestX-rayandelectro-cardiography(ECG)(Ⅲ);一、支持治疗c.Enteralnutritionispreferred,includinghigh-carbohydrate（碳水化合物）,low-fat,moderateproteindiet,providing
3、35-40kcal/kgtotalcalories;forpatientswithHE,proteinintakebyintestinalshouldbelimited;forpatientswithhypoalimentation（营养不良）,adequateliquidandvitaminsupplementationshouldbedeliveredintravenouslytoguaranteeadailytotalenergyintake(Ⅲ);d.Itisnecessarytoactivelyrectify（纠正）lowproteinemia,
4、andsupplyalbuminorfreshplasmaandbloodcoagulationfactorsasappropriate(Ⅲ);e.Monitoringarterialbloodgasisdoneifrequired,correctingthedisturbanceofwaterandelectrolytesaswellasacid-baseequilibrium,especiallyhyponatremia（低钠血症）,hypochloraemia（低氯血症）,hypopotassaemia（低钾血症）andalkalosis（碱中毒）(
5、Ⅲ);Hyponatremiaisacommoncomplicationofdecompensated(失代偿)cirrhosis.Hyponatremia,refractoryascites（顽固性腹水）andacutekidneyinjury(AKI)arecommonlyinterrelatedwitheachother.Waterrestriction,asappropriate,combinedwithdiuretics（利尿剂）,iseffectiveforhyponatremiaandthus,preventsthesubsequentcom
6、plications;一、支持治疗ForHBVDNA(+)patientswithliverfailure,antiviraltherapyisrelativelyeffectiveintheearlyandmiddlestages;butforpatientswithadvancedstageofliverfailure,duetotheseverelydamageofresidualhepatocytesandregenerativecapacityoftheliver,antiviraltreatmentisunlikelytoimproveoutc
7、ome；Fordrug-inducedliverinjury(DILI),anypresumedorpossibleoffendingagentshouldbestoppedimmediately(Ⅲ),documentingallagentstakenoverthepastsixmonthsincludingprescriptiondrugs,non-prescriptiondrugs,herbs,dietarysupplements(Ⅲ)二、病因治疗Forpatientsaffectedbyparacetamol（醋氨酚）、acetaminophen(
8、APAP)（对乙酰氨基酚）,N-acetylcysteine(NA
