白蛋白与肝硬化.pptxVIP

人血白蛋白在肝硬化治疗领域中的应用;概 要;人血白蛋白制品;白蛋白分子特性;白蛋白的生理功能;适应症;不良反应——与血浆相比要低得多;禁忌症;小 结;概 要;肝硬化概念;病 因;肝硬化病理生理与主要并发症;Slight decrease in effective arterial blood volume;RAA, renin-angiotensin-aldosterone; ADH, antidiuretic hormone;Prognostic scoring of cirrhosis肝硬化预后评分;概 要; 白蛋白在肝硬化并发症的治疗;Ascites;RAA, renin-angiotensin aldosterone; ADH, antidiuretic hormone;Grading of ascites腹水分级;轻、中度腹水治疗;补充白蛋白对利尿剂效果的影响(RCT);Results1: 白蛋白增加了利尿剂的治疗效果！;Further evidence for the effects of albumin on survival in patients with ascites was provided by an open-label randomised comparative study of 100 patients. The aim of this study was to determine the effects of albumin administration on the survival of patients, recurrence of ascites and incidence of further complications. Patients admitted to hospital with first-onset ascites were randomised to receive either diuretics plus albumin or diuretics alone. Albumin was administered at a dose of 25 g per week for the first year of the study, progressing to 25 g every 2 weeks for the remaining study period. ;Results:长期的白蛋白补充显著提高腹水患者生存率！;大量腹水的治疗;穿刺后循环功能障碍(PPCD)的发生机制;穿刺后循环功能障碍 (PPCD);常用的血容量扩张剂;大容量穿刺扩容剂的比较研究;Results : 白蛋白优于其他扩容剂！;p=0.02;Evidence comparing albumin and dextran 70 and gelatin in large-volume paracentesis;European guidelines for LVP;American guidelines for LVP;Home treatment of ascites with albumin;小 结; 白蛋白在肝硬化并发症的治疗;自发性细菌性腹膜炎(SBP);自发性细菌性腹膜炎(SBP);自发性细菌性腹膜炎(SBP);SBP肾损害;Effects of albumin infusion on renal impairment in SBP;Results: 白蛋白联合抗生素（头孢噻肟）有效预防了SBP肾损害！降低了在院以及3个月死亡率！;Albumin infusion in SBP;Results : Albumin infusion in SBP;小 结; 白蛋白在肝硬化并发症的治疗;肝肾综合征;肝肾综合征的病理生理机制;Marked decrease in effective arterial blood volume;Pathogenesis of hepatorenal syndrome;HRS, hepatorenal syndrome Ginès et al. Lancet 2003; 362: 1819–1827; Lameire et al. Lancet 2005; 385: 417–430 ;Classification of hepatorenal syndrome: Type 1;Classification of hepatorenal syndrome: Type 2;肝肾综合征对肝移植结局的影响;肝肾综合征治疗史对移植后结局的影响;Initial management of hepatorenal syndrome: a checklist