Kaplan Alyson, Rosenblatt Russell
Department of Gastroenterology and Hepatology, New York Presbyterian, Weill Cornell Medicine, New York, NY USA.
Curr Treat Options Gastroenterol. 2022;20(2):144-159. doi: 10.1007/s11938-022-00377-y. Epub 2022 Mar 17.
Though it is well known that cirrhosis is associated with significant morbidity and mortality, management of symptoms in cirrhosis can be difficult. This review serves to offer practical guidance in the management of liver-specific symptoms of cirrhosis as well as other symptoms with special hepatic considerations.
We discuss liver-specific symptoms and management, including ascites and refractory ascites, hepatic encephalopathy, pruritus, and muscle cramping. We also discuss the challenges of treating more generalized symptoms in cirrhosis, including pain, depression/anxiety, appetite, and fatigue. Medication management is, especially complex in this population given the altered metabolism of drugs, and we consider some strategies to approach this.
With the right tools, provided throughout this review, hepatologists should be well equipped to manage the nuanced liver-specific and generalized symptoms in patients with cirrhosis.
尽管众所周知肝硬化与显著的发病率和死亡率相关,但肝硬化症状的管理可能具有挑战性。本综述旨在为肝硬化肝脏特异性症状以及具有特殊肝脏考量的其他症状的管理提供实用指导。
我们讨论肝脏特异性症状及其管理,包括腹水和难治性腹水、肝性脑病、瘙痒和肌肉痉挛。我们还讨论了肝硬化中治疗更普遍症状的挑战,包括疼痛、抑郁/焦虑、食欲和疲劳。鉴于药物代谢改变,该人群的药物管理尤其复杂,我们考虑了一些应对策略。
借助本综述中提供的正确工具,肝病学家应具备充分能力来管理肝硬化患者细微的肝脏特异性和普遍症状。