Schuster M J
Medizinische Klinik Fachbereich Gastroenterologie Städtische Kliniken Esslingen Akademisches Lehrkrankenhaus der Universität Tübingen Hirschlandstrasse 97 D-73730 Esslingen.
Praxis (Bern 1994). 2003 Aug 27;92(35):1427-34. doi: 10.1024/0369-8394.92.35.1427.
Patients with cirrhosis of the liver are at high risk of a large variety of complications. Especially the development of portal hypertension, followed by gastroesophageal varicosis and ascites are potentially life threatening problems. In the treatment of gastroesophageal varicosis primary prophylaxis to prevent a first bleeding episode, acute therapy for bleeding varices, and secondary prophylaxis to prevent patients from rebleeding have to be considered. While treating patients with ascites the high frequency of side effects induced by diuretics has to be taken into account. In addition, the diagnosis of spontaneous bacterial peritonitis must not be missed. Hepatorenal syndrome, a typical complication of advanced cirrhosis is especially difficult to treat and is considered an indication for liver transplantation.
肝硬化患者面临多种并发症的高风险。尤其是门静脉高压的发展,继而引发胃食管静脉曲张和腹水,这些都是潜在的危及生命的问题。在胃食管静脉曲张的治疗中,必须考虑预防首次出血发作的一级预防、治疗静脉曲张出血的急性治疗以及预防患者再次出血的二级预防。在治疗腹水患者时,必须考虑利尿剂引起的副作用的高发生率。此外,不能漏诊自发性细菌性腹膜炎。肝肾综合征是晚期肝硬化的典型并发症,尤其难以治疗,被视为肝移植的指征。