The principles of acute liver failure treatment are early detection, comprehensive treatment, and prevention and control of complications. 1. General supportive treatment (1) Bed rest, reduce physical exertion, and reduce the burden on the liver. High-carbohydrate, low-fat, moderate protein diet; for those who do not eat enough, intravenous replenishment of sufficient fluids and vitamins daily to ensure more than 1500 kcal total calories per day. Replenish albumin or fresh plasma, and supplement coagulation factors as appropriate. Maintain electrolyte and acid-base balance, pay special attention to correct hyponatremia, hypochlorhydria, hypokalemia and alkalosis. Strengthen nursing care and prevent the occurrence of intra-hospital infection. 2. Treatment for etiology and pathogenesis (1) Treatment for etiology: For patients with HBV DNA-positive liver failure, fast-acting nucleoside analogues such as lamivudine and entecavir can be used as early as possible and appropriate on the basis of informed consent. (2) Hormone therapy: There are still different opinions on the application of adrenocorticosteroids in the treatment of liver failure. Non-viral infectious liver failure, such as autoimmune liver disease and severe alcoholic hepatitis, are indications. In the early stage of liver failure due to other causes, if the disease develops rapidly and there are no serious infections, bleeding and other complications, it can be used as appropriate (3) Hepatocyte growth promotion therapy: To reduce hepatocyte necrosis and promote hepatocyte regeneration, drugs such as hepatocyte growth promoter and prostaglandin El liposome can be used as appropriate. (4) Other treatment: intestinal microecological regulators, lactulose or lactitol can be applied to reduce intestinal bacterial translocation or endotoxemia; microcirculatory improvement drugs and antioxidants, such as acetylcysteine and reduced glutathione, can be used as appropriate. 3. Prevention and control of complications (1) Hepatic encephalopathy: ① Remove causative factors, such as severe infection, bleeding and electrolyte disorders. (2) Restrict protein diet. (3) Apply lactulose or lactitol, acidify the intestine orally or by high enema to promote the excretion of ammonia and reduce the absorption of toxins of intestinal origin. ④Apply ammonia-lowering drugs such as ornithine menadione and use branched-chain amino acids to correct amino acid imbalance. ⑤ Artificial liver support therapy. (2) Cerebral edema: ①Give highly osmotic dehydrating agents, such as 20% mannitol or glycerol fructose, but use with caution in patients with hepatorenal syndrome. (2) loop diuretics, usually furosemide, can be used alternately with osmotic dehydrating agents. (3) Hepatorenal syndrome: ①High-dose loop diuretic shock, furosemide can be continuously pumped. ②Limit fluid intake, total 24h intake should not exceed urine volume plus 500-700ml. ③Inadequate renal perfusion pressure can apply albumin to expand the volume or add terlipressin and other drugs, but patients with acute liver failure should use terlipressin with caution to avoid aggravating cerebral edema due to increased cerebral blood flow. (4) Infection: ①Patients with liver failure are prone to co-infection due to low immune function, imbalance of intestinal microecology, reduced intestinal mucosal barrier and more invasive operations. ②The common ones are spontaneous peritonitis, pulmonary infection and sepsis. ③The common pathogens of infection are bacteria such as Escherichia coli, gram-negative bacilli, staphylococci, Streptococcus pneumoniae, anaerobic bacteria, enterococci and fungi such as Pseudomonas aeruginosa. ④ Once an infection occurs, the first step should be to use strong antimicrobial agents or a combination of antimicrobial agents according to experience, and microecological regulators can be added at the same time. As far as possible, pathogen isolation and drug sensitivity test should be conducted before applying antimicrobial agents, and medication should be adjusted according to the results of drug sensitivity test. Also pay attention to the prevention and control of secondary infections.