酒精使用障碍与酒精相关的肝病:同一枚硬币的两面
Ashwani K Singal1,2,3,4, Lorenzo Leggio5,6,7,8, Andrea DiMartini9
1Department of Medicine, University of South Dakota, Vermillion, South Dakota, USA.
概括
酒精相关性肝病 (ALD) 是肝移植 (LT) 的主要原因之一. 在LT项目中,对酒精使用障碍 (AUD) 和ALD的综合护理可以减少移植后的酒精复发.
科学领域:
- 肝病学和成医学 肝病学和成医学
- 移植手术 移植手术
背景情况:
- 酒精相关性肝病 (ALD) 是全球肝移植 (LT) 的首要征兆,在COVID-19大流行期间,尤其是年轻人群体中,肝移植负担显著增加.
- 酒精使用障碍 (AUD) 影响75-80%的ALD患者,给LT后的康复带来了挑战,并增加了酒精复发的风险.
研究的目的:
- 突出在肝移植计划中对综合护理模式的关键需求,以解决AUD和ALD.
- 强调多学科团队在管理经过LT的AUD患者和减少移植后酒精复发的重要性.
主要方法:
- 审查当前的做法和新出现的数据对管理AUD在ALD患者接受LT.在ALD患者.
- 讨论综合护理的障碍,并推广包括肝病学家和成专家在内的配色诊所模式.
- 强调通过自我报告和生物标志物 (如脂乙醇) 定期监测酒精使用情况.
主要成果:
- 在LT计划中综合AUD治疗显示出在LT后减少反复使用酒精的前景.
- 多学科的护理团队对于在LT候选人和接受者中成功管理AUD和ALD至关重要.
- 现有的综合护理模式往往仅限于评估和选择阶段.
结论:
- 肝移植计划必须优先建立综合,多学科的护理团队,以全面治疗AUD和ALD,以改善严重酒精相关肝炎患者的治疗结果.
- 早期肝移植 (eLT) 仍然是精选患者的重要选择,但其成功取决于整个移植过程中的强大,综合的AUD管理.
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