■肝硬化是由于进行性肝损伤和纤维化引起的任何病因的慢性肝病的结果。因此,肝硬化导致门静脉高压和肝功能障碍,进展为腹水等并发症,静脉曲张出血,肝性脑病,肝肾综合征,肝肺综合征,肝硬化心肌病,少肌症,肝细胞癌,和凝血障碍。终末期肝病导致生活质量受损,社会和经济生产力的丧失,降低了存活率。
■这篇叙述性综述解释了肝硬化并发症的病理生理学,诊断方法和创新管理,关注印度的数据。对已发表的数据进行了全面的文献检索,诊断,以及肝硬化及其并发症的管理。
■代谢综合征的流行病学发生了变化,生活方式疾病,饮酒和肝硬化患者的病因诊断。随着慢性乙型肝炎的普遍疫苗接种和有效的长期病毒抑制剂的出现,慢性丙型肝炎的直接作用抗病毒药物的可用性,以及全国各地蓬勃发展的肝移植计划,并发症的处理至关重要。肝硬化并发症的护理标准有几项更新,比如肝肾综合征,肝细胞癌,和肝性脑病,以及针对晚期肝硬化的支持和姑息治疗的新疗法。
■预防,早期诊断,并发症的适当管理,及时移植是肝硬化和门脉高压治疗方案的基石。印度需要改善获得护理的机会,病毒性肝炎护理公共卫生方案的推广,卫生基础设施,和疾病登记处,以改善医疗保健结果。像免疫接种这样的低成本计划,戒酒,对肝脏疾病的认识,消除病毒性肝炎,在印度,以患者为中心的决策算法对于管理肝病至关重要。
UNASSIGNED: Cirrhosis is the outcome of chronic liver disease of any etiology due to progressive liver injury and fibrosis. Consequently, cirrhosis leads to portal hypertension and liver dysfunction, progressing to complications like ascites, variceal bleeding, hepatic encephalopathy, hepatorenal syndrome, hepatopulmonary syndrome, cirrhotic cardiomyopathy, sarcopenia, hepatocellular carcinoma, and coagulation disorders. End-stage liver disease leads to an impaired quality of life, loss of social and economic productivity, and reduced survival.
UNASSIGNED: This narrative review explains the pathophysiology of complications of cirrhosis, the diagnostic approach and innovative management, with focus on data from India. A comprehensive literature search of the published data was performed in regard with the spectrum, diagnosis, and management of cirrhosis and its complications.
UNASSIGNED: There is a change in the epidemiology of metabolic syndrome, lifestyle diseases, alcohol consumption and the spectrum of etiological diagnosis in patients with cirrhosis. With the advent of universal vaccination and efficacious long-term viral suppression agents for chronic hepatitis B, availability of direct-acting antiviral agents for chronic hepatitis C, and a booming liver transplantation programme across the country, the management of complications is essential. There are several updates in the standard of care in the management of complications of cirrhosis, such as hepatorenal syndrome, hepatocellular carcinoma, and hepatic encephalopathy, and new therapies that address supportive and palliative care in advanced cirrhosis.
UNASSIGNED: Prevention, early diagnosis, appropriate management of complications, timely transplantation are cornerstones in the management protocol of cirrhosis and portal hypertension. India needs improved access to care, outreach of public health programmes for viral hepatitis care, health infrastructure, and disease registries for improved healthcare outcomes. Low-cost initiatives like immunization, alcohol cessation, awareness about liver diseases, viral hepatitis elimination, and patient focused decision-making algorithms are essential to manage liver disease in India.