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目的 探讨儿童肝衰竭的临床特征。方法 应用EXCELL 2 0 0 0软件和t检验分析了本院收治的 10 5例儿童肝衰竭临床资料。结果 ( 1)急性肝衰竭 9例 ,亚急性肝衰竭 38例 ,慢性肝衰竭5 8例。 ( 2 )发病人数最多的是学龄期 7～ 12岁儿童组 4 3例 ( 4 1 0 % ) ;其次是婴儿组 30例 ( 2 8 6 % )。( 3)婴儿组中 13例 ( 4 3 3% )病因不明 ,占第 1位 ;其次为CMV感染 9例 ( 30 0 % )。 1岁以上组病因以HBV感染最多 ,有 2 2例 ( 2 9 3% ) ;病因不明 2 1例 ( 2 8 0 % ) ;肝豆状核变性 15例 ( 2 0 0 % ) ;HAV感染 10例 ( 13 3% )。 ( 4 )合并症中 71例 ( 6 7 6 % )合并腹水 ,合并自发性腹膜炎 34例 ,占有腹水病例的4 7 9%。合并其他部位感染的有 35例 ( 33 3% ) ,感染最多的是肺部感染 ,其次则是败血症。 5 1例( 4 8 6 % )合并电解质紊乱 ,低钾见于所有电解质紊乱的病例。 4 8例 ( 4 6 2 % )合并肝性脑病 ,肝性脑病在儿童中有其特殊的临床表现。 ( 5 )本组 77 2 % ( 71 92 )患儿合并低血糖。结论 儿童肝衰竭病因与年龄有较大的关系。在婴儿组中主要是由CMV感染引起 ,但近一半病因不明。年长组以HBV和HAV感染为主 ,但在引起儿童肝衰竭的其他因素中肝豆状核变性是最常见的。在临床中必须注意儿童肝性脑病的特殊表现
Objective To investigate the clinical features of children with liver failure. Methods The clinical data of 105 children with liver failure admitted to our hospital were analyzed by software EXCELL 2000 and t-test. Results (1) 9 cases of acute liver failure, 38 cases of subacute liver failure, and 58 cases of chronic liver failure. (2) The most frequent cases were 43 cases (41.0%) in school-age children aged 7-12 years, followed by 30 cases (286%) in infants. (3) Thirteen infants (43.3%) had unknown etiology, accounting for the first one; followed by CMV infection in 9 (30%). In group 1, the most common cause of HBV infection was 2 2 (29.3%), 21 (280%) with unknown etiology, 15 (20%) hepatolenticular degeneration, 10 Example (13 3%). (4) Comorbidity in 71 cases (67.6%) with ascites, complicated by spontaneous peritonitis in 34 cases, accounting for 47.9% of cases of ascites. In 35 cases (33.3%) with other parts of the infection, the most common infection was pulmonary infection, followed by sepsis. 51 cases (486%) with electrolyte imbalance, low potassium found in all cases of electrolyte imbalance. Forty-eight cases (46.2%) had hepatic encephalopathy, and hepatic encephalopathy had a special clinical manifestation in children. (5) This group of 77 2% (71 92) children with hypoglycemia. Conclusion The causes of liver failure in children have a greater relationship with age. In the infant group, it is mainly caused by CMV infection, but nearly half of the causes are unknown. Elderly patients are predominantly infected with HBV and HAV, but Wilson’s disease is most common among other factors that cause liver failure in children. In clinical must pay attention to the special performance of children with hepatic encephalopathy