Liver Failure Review: ALT, Encephalopathy and Portal Pressure | Part 2 | 肝衰竭 | OET Music

Dr Allison Lu · Pip & Barnaby · Medical English

本頁提供本曲完整英文歌詞與影片搭配的繁中醫學提示。歌詞保留原演唱文字；遇到過度簡化或舊門檻，請搭配下方提示與原始資料閱讀。這是概念學習材料，不替代個別醫療評估。

Lyrics · 完整歌詞

The central distinctions can be recalled as follows.

All acute liver failure requires an INR of at least 1.5 plus
encephalopathy in a previously healthy liver,
within 26 weeks.
Is the ALT falling while the INR rises?
Then hepatocytes are exhausted, not recovering,
and the transplant unit must be called.
On a bleeding cirrhotic, airway and volume come before endoscopy,
terlipressin and ceftriaxone before banding, and propranolol never in the acute phase.
Lucid or drowsy, the patient's ammonia does not grade the failure; bilirubin,
INR and encephalopathy do.


All acute liver failure requires an INR of at least 1.5 plus
encephalopathy in a previously healthy liver,
within 26 weeks.
Is the ALT falling while the INR rises?
Then hepatocytes are exhausted, not recovering,
and the transplant unit must be called.
On a bleeding cirrhotic, airway and volume come before endoscopy,
terlipressin and ceftriaxone before banding, and propranolol never in the acute phase.
Lucid or drowsy, the patient's ammonia does not grade the failure; bilirubin,
INR and encephalopathy do.

Medical Notes · 醫學學習提示

  1. 重點複習：急性肝衰竭定義、趨勢判讀與出血救治
  2. 成人常用定義包括 INR ≥1.5，仍須合併其他條件
  3. 合併肝性腦病，通常無既往肝硬化；特殊病因可有例外
  4. 常用病程界線為二十六週內；兒童定義不同
  5. ALT 下降同時 INR 上升，不能單憑 ALT 判定好轉
  6. 可能反映嚴重肝細胞損失，但兩個數值不能單獨確診原因
  7. 應及早聯絡肝臟專科或移植中心，不必等達移植判準
  8. 先評估氣道與灌流、適度復甦；插管依意識及吐血情況
  9. 疑曲張出血即用適當藥物；不穩定期先停 β 阻斷劑
  10. 血氨不能單獨分級；須結合意識與其他檢驗趨勢
  11. 綜合 INR、膽紅素、腦病與腎等器官功能評估

References