肝硬化患者的感染风险与管理:批判性综述
Infection risk and management in patients with cirrhosis: A critical overview.
作者信息
Suárez Miguel, Martínez Raquel, Gómez-Molina Raquel, Mateo Jorge
机构信息
Department of Gastroenterology, Virgen de la Luz Hospital, Cuenca 16002, Castille-La Mancha, Spain.
Medical Analysis Expert Group, Institute of Technology, Universidad de Castilla-La Mancha, Cuenca 16071, Castille-La Mancha, Spain.
出版信息
World J Hepatol. 2025 May 27;17(5):104468. doi: 10.4254/wjh.v17.i5.104468.
In this paper, we analyze the article published by El Labban , which explores the impact of cirrhosis on patients with necrotizing fasciitis. The authors conclude that cirrhosis is a significant risk factor for increased in-hospital morbidity and mortality in this patient population. Building upon their final observation regarding the importance of understanding this association, we will delve into the topic of infections in patients with liver cirrhosis. These patients exhibit intrinsic characteristics that make them particularly susceptible to infections, both bacterial and fungal. This heightened risk not only increases the likelihood of severe infections but also makes them a common trigger for acute decompensations, including the development of acute-on-chronic liver failure, which markedly worsens prognosis and mortality. Infections in patients with cirrhosis often require a more aggressive and rapid diagnostic and therapeutic approach due to the higher risk of nosocomial infections, multidrug-resistant organisms, and atypical clinical presentations. Delayed or inadequate management can lead to unfavorable outcomes, further complicating the course of their underlying liver disease. The aim of this article is to emphasize the importance of early and appropriate management in patients with cirrhosis with infections. Evidence supports that timely and tailored interventions not only improve clinical outcomes but also reduce mortality. By raising awareness among clinicians about the complexity of these cases, we hope to contribute to optimizing the care of this high-risk population.
在本文中,我们分析了埃尔·拉班发表的文章,该文章探讨了肝硬化对坏死性筋膜炎患者的影响。作者得出结论,肝硬化是该患者群体住院发病率和死亡率增加的重要危险因素。基于他们对理解这种关联重要性的最终观察结果,我们将深入探讨肝硬化患者的感染问题。这些患者具有一些内在特征,使他们特别容易受到细菌和真菌感染。这种更高的风险不仅增加了严重感染的可能性,还使感染成为急性失代偿的常见触发因素,包括慢加急性肝衰竭的发生,这会显著恶化预后和死亡率。由于医院感染、多重耐药菌和非典型临床表现的风险较高,肝硬化患者的感染通常需要更积极、快速的诊断和治疗方法。延迟或不充分的治疗可能导致不良后果,使他们潜在的肝脏疾病病程更加复杂。本文的目的是强调对肝硬化合并感染患者进行早期和适当治疗的重要性。有证据表明,及时且量身定制的干预措施不仅能改善临床结局,还能降低死亡率。通过提高临床医生对这些病例复杂性的认识,我们希望有助于优化对这一高危人群的护理。
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