肾脏替代疗法治疗肝肾综合征的研究进展

Research advances in renal replacement therapy for hepatorenal syndrome

肝肾综合征(HRS)是终末期肝病的严重并发症,其总体治疗效果并不理想,生存时间短,预后差。肾脏替代治疗是目前主要的非移植治疗手段之一,但其疗效仍然存在争议。叙述了HRS的概况及肾脏替代治疗在治疗HRS临床疗效的最新进展。认为肾脏替代治疗不应作为HRS的常规治疗措施,但可用于计划性肝移植患者的移植前过渡性治疗,以及对血管收缩药物无效的非肝移植患者的短期治疗。

Hepatorenal syndrome（ HRS） is a serious complication of the end- stage liver disease. The overall treatment outcome of HRS is not satisfactory,with a short survival time and a poor prognosis. Currently,renal replacement therapy is one of the main non- transplantation therapeutic methods,but its clinical effect remains controversial. This review summarizes the research on HRS and advances in the clinical effect of renal replacement therapy for HRS,and points out that renal replacement therapy is not suitable as the conventional therapy for HRS,but it can be applied as the pre- transplantation transitional treatment for patients with a plan for liver transplantation,as well as the short- term treatment for non- transplantation patients who do not respond to vasoconstrictors.