Protopapas Adonis A, Tsankof Alexandra, Papagiouvanni Ioanna, Kaiafa Georgia, Skoura Lemonia, Savopoulos Christos, Goulis Ioannis
First Propaedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki 54636, Greece.
Fourth Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki 54642, Greece.
World J Hepatol. 2024 Dec 27;16(12):1377-1394. doi: 10.4254/wjh.v16.i12.1377.
Acute decompensation in cirrhotic patients signifies the onset of clinically evident events due to portal hypertension. The transition from compensated to decompensated cirrhosis involves hemodynamic changes leading to multiorgan dysfunction, managed predominantly in outpatient settings with regular monitoring. The mortality risk is elevated in decompensated patients. Therefore, diligent outpatient management should focus on regular medical follow-ups, medication adjustments, patient education, addressing emergent issues and evaluation for liver transplantation. The ultimate goal is to improve quality of life, prevent disease progression, reduce complications, and assess possible recompensation. This guide provides valuable recommendations for medical experts managing decompensated cirrhotic patients post-hospitalization.
肝硬化患者的急性失代偿意味着由于门静脉高压导致临床明显事件的发生。从代偿期肝硬化转变为失代偿期肝硬化涉及血流动力学变化,进而导致多器官功能障碍,主要在门诊环境中通过定期监测进行管理。失代偿期患者的死亡风险会升高。因此,精心的门诊管理应侧重于定期医学随访、药物调整、患者教育、处理紧急问题以及评估肝移植情况。最终目标是提高生活质量、预防疾病进展、减少并发症并评估可能的再代偿情况。本指南为管理失代偿期肝硬化患者出院后的医学专家提供了宝贵的建议。