重症肝硬化患者合并肾功能不全

Critically ill cirrhotic patients with renal insufficiency

肝硬化的患者因重症住入监护病房,其预后是相当不良的。由于肝硬化的疾病特性,往往容易造成其他器官的功能异常,包括肝脑病变、肝肾症候群、肝胸症候群等等;若住入监护病房的重症肝硬化患者发生其他器官的功能异常或衰竭,其预后更差。其中,肾功能不全是最被广泛探讨的部分。肾功能不全是肝硬化常见的并发症。据文献统计,若重症肝硬化患者住进监护病房,则急性肾损伤的发生率高达40至60%。肝硬化患者若发生急性肾损伤,往往代表患者的不良预后,存活率大幅下降;因此甚至可用肾功能不全的严重程度作为肝硬化患者预后的评估指标。

Cirrhotic patients admitted to intensive care units （ICUs） have high mortality rates. Due to the characteristics of liver cirrhosis, cirrhotic patients frequently have multi-organ dysfunctions including hepatic encephalopathy, hepato-renal syndrome, hepato-pulmonary syndrome, etc. The prognosis is even worse in ICU cirrhotic patients with extra-hepatic organ system failure or dysfunction. Moreover, renal insufficiency which is widely discussed is a common complication of cirrhosis. According to literature reviews, the inci- dence of acute kidney injury （AKI） is up to 40-60% in ICU cirrhotic patients. The occurrence of AKI repre- sents poor prognosis and increased mortality rate. Therefore, we can use the severity of the renal function im- pairment as the outcome predictor among these patients.