Pay attention to the multimodality therapy and long-term management for liver cirrhosis
-
摘要: 肝硬化是慢性乙型肝炎、丙型肝炎、酒精性及非酒精性脂肪性肝病等多种慢性肝病的共同结局,主要表现为肝细胞功能障碍和门静脉高压症及其并发症。结合病史,可根据内镜、影像、生化、血液学指标做出肝硬化的临床诊断。肝硬化的诊断应尽可能明确病因、疾病分期和肝功能分级;治疗应尽可能包括病因治疗、综合支持治疗和针对各种并发症的治疗措施,并对患者进行长期随访和监测,以达到延缓疾病进展、延长生存期和提高生活质量的目标。Abstract: Liver cirrhosis is the end-stage of various liver diseases including chronic hepatitis B, hepatitis C, alcoholic and nonalcoholic fatty liver diseases, with the main manifestations of hepatocyte dysfunction, portal hypertension and a series of complications. A clinical diagnosis of liver cirrhosis can be made based on medical history and the results of endoscopy, radiology, biochemistry, and hematological tests. Etiology, disease stage, and liver function reserve should be clarified for the diagnosis of liver cirrhosis. Treatment should include etiological therapy, comprehensive supportive therapy, and measures for various complications, aiming to prolong survival and improve quality of life. Long-term follow-up should be performed to monitor disease progression, evaluate therapeutic efficacy.
-
Key words:
- Liver Cirrhosis /
- Portal Hypertension /
- Therapeutics /
- Disease Management
-
[1] GBD 2017 Cirrhosis Collaborators. The global, regional, and national burden of cirrhosis by cause in 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017[J]. Lancet Gastroenterol Hepatol, 2020, 5(3): 245-266 DOI: 10.1016/S2468-1253(19)30349-8 [2] LI M, WANG ZQ, ZHANG L, et al. Burden of cirrhosis and other chronic liver diseases caused by specific etiologies in China, 1990-2016: Findings from the Global Burden of Disease Study 2016[J]. Biomed Environ Sci, 2020, 33(1): 1-10. [3] WANG X, LIN SX, TAO J, et al. Study of liver cirrhosis over ten consecutive years in Southern China[J]. World J Gastroenterol, 2014, 20(37): 13546-13555. DOI: 10.3748/wjg.v20.i37.13546 [4] TSOCHATZIS EA, BOSCH J, BURROUGHS AK. Liver cirrhosis[J]. Lancet, 2014, 383(9930): 1749-1761. [5] Chinese Society of Hepatology, Chinese Medical Association. Chinese guidelines on the management of liver cirrhosis[J]. J Clin Hepatol, 2019, 35(11): 2408-2425.(in Chinese) DOI: 10.3969/j.issn.1001-5256.2019.11.006中华医学会肝病学分会. 肝硬化诊治指南[J]. 临床肝胆病杂志, 2019, 35(11): 2408-2425. DOI: 10.3969/j.issn.1001-5256.2019.11.006 [6] D'AMICO G, MORABITO A, D'AMICO M, et al. New concepts on the clinical course and stratification of compensated and decompensated cirrhosis[J]. Hepatol Int, 2018, 12(Suppl 1): 34-43. http://europepmc.org/abstract/MED/28681347 [7] ZHAO H, WANG Q, LUO C, et al. Recompensation of decompensated hepatitis B cirrhosis: Current status and challenges[J]. Biomed Res Int, 2020, 2020: 9609731. http://www.researchgate.net/publication/345363511_Recompensation_of_Decompensated_Hepatitis_B_Cirrhosis_Current_Status_and_Challenges [8] GARCIA-TSAO G, ABRALDES JG, BERZIGOTTI A, et al. Portal hypertensive bleeding in cirrhosis: Risk stratification, diagnosis, and management: 2016 practice guidance by the American Association for the Study of Liver Diseases[J]. Hepatology, 2017, 65(1): 310-335. DOI: 10.1002/hep.28906 [9] European Association for the Study of the Liver. EASL clinical practice guidelines for the management of patients with decompensated cirrhosis[J]. J Hepatol, 2018, 69(2): 406-460. DOI: 10.1016/j.jhep.2018.03.024 [10] BUNCHORNTAVAKUL C, REDDY KR. Review article: Malnutrition/sarcopenia and frailty in patients with cirrhosis[J]. Aliment Pharmacol Ther, 2020, 51(1): 64-77. DOI: 10.1111/apt.15571 [11] TANDON P, BERZIGOTTI A. Management of lifestyle factors in individuals with cirrhosis: A pragmatic review[J]. Semin Liver Dis, 2020, 40(1): 20-28. DOI: 10.1055/s-0039-1696639 [12] MELLINGER JL, VOLK ML. Multidisciplinary management of patients with cirrhosis: A need for care coordination[J]. Clin Gastroenterol Hepatol, 2013, 11(3): 217-223. DOI: 10.1016/j.cgh.2012.10.040
本文二维码
计量
- 文章访问数: 890
- HTML全文浏览量: 327
- PDF下载量: 216
- 被引次数: 0