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《肝衰竭治療ppt課件》由會員上傳分享，免費(fèi)在線閱讀，更多相關(guān)內(nèi)容在教育資源-天天文庫。
1、肝衰竭的治療XXX市人民醫(yī)院支持治療1病因治療2并發(fā)癥治療4其他治療3CONTENTS目錄一、支持治療Bedrest,reducingenergyconsumption,andalleviating(緩解)theburdenoftheliver(Ⅲ);MonitoringPTA/INR,bloodammonia(血氨)andbloodbiochemicalindices,analyzingarterialbloodlactate（乳酸）,endotoxin（內(nèi)毒素）,hepadnavirusmarkers（嗜肝DNA病毒）,ceruloplasmin（銅蘭
2、蛋白）,antibodiesofautoimmuneliverdiseases（自免肝抗體）,andexaminingabdomenbyB-ultrasound(liver,gallbladder,spleenandpancreas,ascites),takingchestX-rayandelectro-cardiography(ECG)(Ⅲ);一、支持治療c.Enteralnutritionispreferred,includinghigh-carbohydrate（碳水化合物）,low-fat,moderateproteindiet,providing
3、35-40kcal/kgtotalcalories;forpatientswithHE,proteinintakebyintestinalshouldbelimited;forpatientswithhypoalimentation（營養(yǎng)不良）,adequateliquidandvitaminsupplementationshouldbedeliveredintravenouslytoguaranteeadailytotalenergyintake(Ⅲ);d.Itisnecessarytoactivelyrectify（糾正）lowproteinemia,
4、andsupplyalbuminorfreshplasmaandbloodcoagulationfactorsasappropriate(Ⅲ);e.Monitoringarterialbloodgasisdoneifrequired,correctingthedisturbanceofwaterandelectrolytesaswellasacid-baseequilibrium,especiallyhyponatremia（低鈉血癥）,hypochloraemia（低氯血癥）,hypopotassaemia（低鉀血癥）andalkalosis（堿中毒）(
5、Ⅲ);Hyponatremiaisacommoncomplicationofdecompensated(失代償)cirrhosis.Hyponatremia,refractoryascites（頑固性腹水）andacutekidneyinjury(AKI)arecommonlyinterrelatedwitheachother.Waterrestriction,asappropriate,combinedwithdiuretics（利尿劑）,iseffectiveforhyponatremiaandthus,preventsthesubsequentcom
6、plications;一、支持治療ForHBVDNA(+)patientswithliverfailure,antiviraltherapyisrelativelyeffectiveintheearlyandmiddlestages;butforpatientswithadvancedstageofliverfailure,duetotheseverelydamageofresidualhepatocytesandregenerativecapacityoftheliver,antiviraltreatmentisunlikelytoimproveoutc
7、ome；Fordrug-inducedliverinjury(DILI),anypresumedorpossibleoffendingagentshouldbestoppedimmediately(Ⅲ),documentingallagentstakenoverthepastsixmonthsincludingprescriptiondrugs,non-prescriptiondrugs,herbs,dietarysupplements(Ⅲ)二、病因治療Forpatientsaffectedbyparacetamol（醋氨酚）、acetaminophen(
8、APAP)（對乙酰氨基酚）,N-acetylcysteine(NA
