用有限的资源来管理肝硬化:撒哈拉以南非洲的观点
Mark W Sonderup1, Patrick S Kamath2, Yaw A Awuku3
1Division of Hepatology, Department of Medicine, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa.
The lancet. Gastroenterology & hepatology
|January 12, 2024
概括
肝硬化,肝脏疾病的末期,在撒哈拉以南非洲是一个重大的健康挑战. 早期诊断和可访问的管理策略对于改善这个资源有限的地区患者的治疗结果至关重要.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 公共卫生 公共卫生
- 内部医学 内部医学
背景情况:
- 肝硬化是慢性肝病的晚期阶段,在撒哈拉以南非洲普遍存在,原因是病毒性肝炎,酒精,以及与代谢功能障碍相关的脂肪性肝病 (MASLD) 的上升.
- 肝硬化导致显著的发病率和死亡率,由肝功能障碍和门性高血压加剧.
- 早期诊断至关重要,因为补偿性肝硬化比不补偿性肝硬化提供了更好的预后.
研究的目的:
- 突出挑战和可行的策略,诊断和管理肝硬化在资源有限的环境,如撒哈拉以南非洲.
- 强调解决肝病的根本原因和实施政策干预的重要性.
主要方法:
- 对资源有限的环境中肝硬化目前的诊断和管理方法的审查.
- 讨论不那么侵入性和成本效益的干预措施,包括血液检测和过渡性弹性图像.
- 探索非补偿性肝硬化管理策略,如药物治疗和生活方式改变.
主要成果:
- 在撒哈拉以南的非洲,成本效益低的,侵入性较小的诊断工具,如血液检测和过渡性弹性图形,是可行的.
- 已建立的干预措施可用于管理诸如炎,水出血和肝脏脑病变等并发症.
- 针对乙型肝炎和型肝炎查,减少饮酒和管理MASLD的政策干预是必不可少的.
结论:
- 在撒哈拉以南非洲,有效的肝硬化管理依赖于早期诊断,可访问的干预措施和解决根本原因.
- 加强区域卓越中心的特殊程序,如肝移植至关重要.
- 政策层面的变化和专门的举措是改善肝硬化患者预后的关键.
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