Prospective management of cirrhosis

摘要

Abstract: An increasing number of patients are presenting with cirrhosis; thus, understanding and taking a prospective approach to their management is becoming essential, Cirrhosis is the final common pathway for many causes of chronic liver disease. Mortality rates dramatically increase when patients progress from compensated to decompensated cirrhosis. Close monitoring and early intervention is needed to delay this progression and improve survival once complications do arise. Patients should be monitored for clinical deterioration and, worsening of laboratory values, and care should be taken to ensure adequate nutrition and avoidance of hepatotoxic medications. Susceptible patients may require immunization. Family members should be screened for contagious and inheritable causes of liver diseases, and screening for hepatic encephalopathy, varices, and hepatocellular carcinoma should be routinely performed. Prophylaxis against spontaneous bacterial peritonitis should be instituted in highrisk patients, and referral for liver transplantation should be made at the appropriate time.