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目的:探索儿童急性肝衰竭病因构成，优化病因查找方向、评估短期疗效。方法:收集2011年11月至2019年11月就诊于郑州大学第一附属医院并确诊的儿童急性肝衰竭病例，统计不同性别、年龄段、居住环境、发病季节的病因构成，并分析不同病因的短期预后情况。率的比较和组间构成比比较采用χn 2检验或Fisher确切概率法。n 结果:236例病例中，病因不明者114例（48.31%），病因明确者122例（51.69%）。在病因明确组中，药物/毒物相关38例（16.10%），感染性相关27例（11.44%），先天发育性/血管性/胆道性相关22例（9.32%），遗传代谢性疾病15例（6.36%），肿瘤相关17例（7.20%），自身免疫性疾病3例（1.27%）；且整体病因分布在不同性别、年龄别及发病季节等因素上差异无统计学意义（n P>0.05），而在不同居住环境上差异有统计学意义（n P0.05），在年龄别、居住环境和发病季节上差异有统计学意义（n P0.05）；而在病因明确组中，上述差异有统计学意义（43.96%比83.87%，n P 0.05), while the difference in different living environments was statistically significant ( n P 0.05), but there were significant differences in age, living environment and seasonal onset ( n P 0.05), while in the definite etiology group, the above differences were statistically significant (43.96% vs. 83.87%, n P < 0.05). Among the different etiology groups, the congenital/vascular/biliary group had the best short-term efficacy (72.72%, 16/22), followed by the drug/toxicity-related group (60.53%, 23/38), and the tumor-related group had the worst (23.53%, 4/17).n Conclusion:The definite etiology of acute liver failure in about half of children is still vague. The population distribution of children with definite etiology is related to age, living environment and season, but not to gender. However, the different ages, different living environments, and different seasonal onsets have definite etiology, and the short-term clinical efficacy of the treatment is significantly improved after the definite etiology is identified.