肝衰竭时胆汁淤积的发生机制及处置对策

Pathogenesis and management strategies of liver failure-associated cholestasis

肝衰竭是多种因素引起的严重肝脏损害。肝衰竭时胆汁淤积是一种以大量肝细胞坏死为主要原因的严重肝细胞性肝内胆汁淤积,表现为结合胆红素和非结合胆红素同时急剧增高,且其水平与肝衰竭严重程度呈正比。肝脏组织结构改变加重胆汁淤积,肠道微生物群对胆红素和胆汁酸代谢有影响。治疗肝衰竭时胆汁淤积的根本措施是去除病因,促进肝细胞再生和肝功能恢复。

Liver failure is severe liver injury caused by a variety of factors.Liver failure-associated cholestasis is serious hepatocellular intrahepatic cholestasis with massive hepatocyte necrosis,which manifests as rapid increases in both conjugated and unconjugated bilirubin,and the level of bilirubin is directly proportional to the severity of liver failure.Structural changes of liver tissue aggravate intrahepatic cholestasis,and intestinal microbiota can affect bilirubin and bile acid metabolism.The management strategies for liver failure-associated cholestasis include eliminating causes,promoting hepatocyte regeneration,and facilitating liver function recovery.