Bhanji R A, Carey E J, Watt K D
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
Division of Gastroenterology and Hepatology, Mayo Clinic, Phoenix, AZ, USA.
Aliment Pharmacol Ther. 2017 Jul;46(1):16-25. doi: 10.1111/apt.14078. Epub 2017 May 2.
With recent advances in the management of chronic liver disease and its complications, the long-term survival in cirrhosis has improved. Therefore, the number of individuals who will spend a significant proportion of their life with end-stage liver disease (ESLD) may continue to rise. Thus, more attention to quality of life (QOL) and its integration with traditional clinical endpoints is needed.
Recently, there have been many studies looking at treatment outcomes and their impact on the QOL in patients with ESLD. The aim of this review was to summarise and compare the insights gained from these intervention studies and to make concise recommendations to further promote and improve QOL in this patient population.
A literature search was conducted using PubMed and Web of Science. Search terms "Quality of life" "Cirrhosis" and "end-stage liver disease" were used as MeSH terms or searched in the title of the article.
These studies uniformly show significant improvement in health-related QOL (HRQOL) with management of malnutrition, hepatic encephalopathy and ascites. Thus, early recognition and management of these complications are keys to better serve our patients. Early involvement of palliative care also leads to improved quality of end-of-life care.
Complications of cirrhosis including malnutrition, encephalopathy, ascites and variceal bleeding lead to a decrease in HRQOL. Assessment of HRQOL has an important implication for the patient. The findings of this review illuminate the importance of using consistent tools to accurately assess QOL in patients with ESLD.
随着慢性肝病及其并发症管理方面的最新进展，肝硬化患者的长期生存率有所提高。因此，患有终末期肝病（ESLD）且生命中很大一部分时间受其影响的人数可能会持续增加。因此，需要更多地关注生活质量（QOL）及其与传统临床终点的结合。
最近，有许多研究关注ESLD患者的治疗结果及其对生活质量的影响。本综述的目的是总结和比较这些干预研究中获得的见解，并提出简明建议，以进一步促进和改善该患者群体的生活质量。
使用PubMed和Web of Science进行文献检索。检索词“生活质量”“肝硬化”和“终末期肝病”用作医学主题词（MeSH）或在文章标题中进行检索。
这些研究一致表明，通过对营养不良、肝性脑病和腹水的管理，与健康相关的生活质量（HRQOL）有显著改善。因此，早期识别和管理这些并发症是更好地为患者服务的关键。姑息治疗的早期介入也能提高临终关怀的质量。
肝硬化的并发症，包括营养不良、脑病、腹水和静脉曲张出血，会导致HRQOL下降。HRQOL评估对患者具有重要意义。本综述的结果阐明了使用一致的工具准确评估ESLD患者生活质量的重要性。
