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肝硬化治疗中易被忽视的因素:病情恶化的隐匿元凶

Forgettable in the care of liver cirrhosis: the unseen culprits of progression from bad to worse.

作者信息

Elsabaawy Maha, Alhaddad Omkosoum

机构信息

Department of Hepatology and Gastroenterology, National Liver Institute, Menoufia University, Shebin Elkom, Menoufia, Egypt.

出版信息

Prz Gastroenterol. 2024;19(1):6-17. doi: 10.5114/pg.2024.136361. Epub 2024 Mar 14.

Abstract

Patients with liver cirrhosis constitute a critically ill and unique population, and their stability relies on a well-coordinated multidisciplinary team with a carefully structured plan. Overlooking any aspect of this plan can expedite disease progression, leading to severe complications. The lack of disease-specific nutritional guidance, the prevalent sedentary lifestyle among patients, and insufficient screening for hepatocellular carcinoma, oesophageal varices, sarcopaenia, minimal hepatic encephalopathy, and diabetes mellitus, along with fibrosis progression and cirrhosis decompensation, can add further complexities. Additionally, devaluing the impact of obesity in triggering liver cirrhosis can be disadvantageous. Prolonged and inappropriate use of proton pump inhibitors also poses a significant challenge with a wide range of complications. These often-unheeded aspects in the care of liver cirrhosis patients represents the unseen culprits of progression from bad to worse and warrant serious consideration.

摘要

肝硬化患者是危重症且独特的群体,他们的病情稳定依赖于一个精心协调的多学科团队以及精心制定的计划。忽视该计划的任何方面都可能加速疾病进展,导致严重并发症。缺乏针对该疾病的营养指导、患者中普遍存在的久坐生活方式、对肝细胞癌、食管静脉曲张、肌肉减少症、轻微肝性脑病和糖尿病筛查不足,以及纤维化进展和肝硬化失代偿,都会增加更多复杂性。此外,低估肥胖在引发肝硬化中的影响可能是不利的。长期不恰当地使用质子泵抑制剂也带来了一系列并发症的重大挑战。这些在肝硬化患者护理中常常被忽视的方面是病情恶化的幕后黑手,值得认真考虑。

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