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1、SeminarAcuteliverfailureWilliamBernal,GeorgAuzinger,AnilDhawan,JuliaWendonLancet2010;376:190–201Acuteliverfailureisararedisorderwithhighmortalityandresourcecost.Inthedevelopingworld,viralcausesLiverIntensiveTherapyUnitpredominate,withhepatitisEinfecti
2、onrecognisedasacommoncauseinmanycountries.IntheUSAandmuchof(WBernalMD,GAuzingerEDIC,westernEurope,theincidenceofvirallyinduceddiseasehasdeclinedsubstantiallyinthepastfewyears,withmostJWendonMD),andcasesnowarisingfromdrug-inducedliverinjury,oftenfrompa
3、racetamol.However,alargeproportionofcasesareofPaediatricLiverServices(ProfADhawanMD),Instituteunknownorigin.AcuteliverfailurecanbeassociatedwithrapidlyprogressivemultiorganfailureanddevastatingofLiverStudies,King’sCollegecomplications;however,outcomes
4、havebeenimprovedbyuseofemergencylivertransplantation.AnevidencebaseHospital,London,UKforpracticeisemergingforsupportivecare,andabetterunderstandingofthepathophysiologyofthedisorder,Correspondenceto:especiallyinrelationtohepaticencephalopathy,willproba
5、blysoonleadtofurtherimprovementsinsurvivalrates.DrWilliamBernal,LiverIntensiveTherapyUnit,InstituteofLiverStudies,King’sIntroductiondoesnotdependonthissymptombutonlyonCollegeHospital,DenmarkHill,Acuteliverfailureistheclinicalmanifestationofcoagulopath
6、yduetoliverinjury.AdesignationacceptedLondonSE59RS,UKsuddenandseverehepaticinjuryandarisesfrommanyforclinicalandresearchstudiesisthatofamultisystemwilliam.bernal@kcl.ac.ukcauses.Afterabruptlossofhepaticmetabolicanddisorderinwhichsevereimpairmentoflive
7、rfunction,immunologicalfunction,itleadstohepaticwithorwithoutencephalopathy,occurswithhepato-encephalopathy,coagulopathy,and,inmanycases,cellularnecrosisinapatientwithnoreportedunderlyingprogressivemultiorganfailure(panel1).Althoughchronicliverdisease
8、.15uncommon,thiscriticalillnessoccursmostlyinyoungadultsandisassociatedwithhighmortalityandIncidenceresourcecost.InmanycountriesitisthemostfrequentAcuteliverfailureisrare.Reportsfromthedevelopedindicationforemergencylivertransplantation.worlds
