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肝肾综合征的治疗进展

李妍 陆伦根 蔡晓波

引用本文:
Citation:

肝肾综合征的治疗进展

DOI: 10.3969/j.issn.1001-5256.2020.11.004
基金项目: 

国家重大科技专项(2018ZX09201016); 

详细信息
  • 中图分类号: R575.2;R692

Advances in the treatment of hepatorenal syndrome

Research funding: 

 

  • 摘要:

    肝肾综合征是失代偿期肝硬化常见的严重并发症之一,是一组继发于有效血容量下降、内源性血管活性物质失衡、肾血流量下降,以肾功能不全为主要表现的临床综合征。肝肾综合征临床上主要表现为肾血流量和肾小球滤过率下降,肾脏组织学往往无显著变化。肝肾综合征一经诊断应尽早开始治疗。目前临床工作中肝肾综合征的治疗手段主要包括:(1)一般支持治疗,积极处理原发疾病及诱因;(2)药物治疗,包括白蛋白和血管活性药物;(3)肾脏替代治疗;(4)分子吸附再循环系统;(5)经颈静脉肝内门体分流术;(6)肝移植。肝移植是肝肾综合征治疗的最佳方案,药物治疗、肾脏替代治疗等通常作为肝移植术前的过渡期治疗。其中,白蛋白联合特利加压素是目前肝肾综合征药物治疗的首选方案。系统综述了肝肾综合征在治疗方面的新概念和新进展。

     

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  • 收稿日期:  2020-08-24
  • 出版日期:  2020-11-20
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