肝移植接受者的肺部评估
Charles Panackel1, Mohammed Fawaz1, Mathew Jacob1
1Integrated Liver Care, Aster Medcity, Kochi, Kerala, India.
Journal of clinical and experimental hepatology
|September 11, 2023
概括
肺部并发症,如肝肺综合征和肺港高血压显著影响肝脏疾病等待肝移植 (LT) 的患者. 这些呼吸道问题的早期诊断和管理改善了LT后的结果.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 肺部病理学 肺部病理学
- 移植医学 移植医学
背景情况:
- 慢性肝病和门高血压经常导致呼吸道并发症.
- 末期肝病的肺部疾病会影响肝移植的结果.
- 严重的肺部问题使肝硬化患者的重症监护复杂化.
研究的目的:
- 审查肝硬化和门性高血压的呼吸系统后果.
- 讨论肝肺综合征 (HPS),肺港高血压 (POPH) 和肝脏胸水 (HH) 对LT的影响.
- 突出前-LT风险分层对于肺部疾病的重要性.
主要方法:
- 审查现有的关于肝硬化肺部疾病的文献.
- 对HPS,POPH和HH的诊断标准和管理策略的分析.
- 评估这些疾病对LT等候名单死亡率和移植后成功的影响.
主要成果:
- 肝肺综合征 (HPS),其特点是肺内血管扩张导致的低氧化,影响5-30%的肝硬化病例,是LT的征兆.
- 肺部肺高血压 (POPH) 需要排除肺高血压的其他原因;严重的POPH是相对LT的禁忌,而中度的POPH可能会从LT中受益.
- 肝脏水胸 (HH) 是一种透性多流,发生在5-10%的肝硬化患者中,耐火病例受益于LT.
结论:
- 肺部疾病是慢性肝病和门门高血压的重要并发症.
- 及时诊断和HPS,POPH和HH的风险分层对于LT候选人至关重要.
- 管理这些条件的进步为LT受益者带来了更好的结果.
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