The management of hospitalized patients with cirrhosis: the Mount Sinai experience and a guide for hospitalists.

Perumalswami PV; Schiano TD

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The management of hospitalized patients with cirrhosis: the Mount Sinai experience and a guide for hospitalists.

机译：住院肝硬化患者的管理：西奈山的经验和住院医生指南。

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BACKGROUND: Cirrhosis and chronic liver disease carry appreciable morbidity and mortality. Cirrhotic patients frequently require hospitalization and their care is both extremely complex and labor-intensive. AIM: We seek to provide a review for gastroenterologists, hepatologists, internists, and hospitalists on the approach to care in patients hospitalized for complications related to end-stage liver disease. METHODS: The Mount Sinai Medical Center's inpatient liver service has developed an integrated team approach for cirrhotic patients and throughout the years has educated fellows-in-training and medical house staff on both the treatment principles and "pearls" in managing the hospitalized cirrhotic patient. We reviewed the literature and provide recommendations on the management of complications of end-stage liver disease. Additionally, we provide a review of the protocols used at our institution in the care for cirrhotic patients. RESULTS: Major complications of advanced liver disease include infection, ascites, spontaneous bacterial peritonitis, hepatic encephalopathy, portal hypertension, variceal hemorrhage, hepatorenal syndrome, and hepatocellular carcinoma. Management of these complications involves selecting the appropriate diagnostic studies and prompt administration of therapy. CONCLUSIONS: There are many complications of cirrhosis. Management of these complications can be complex and are targeted at stabilizing the patient's clinical condition. Liver transplantation remains the only definitive treatment.

机译：背景：肝硬化和慢性肝病具有明显的发病率和死亡率。肝硬化患者经常需要住院治疗，其护理极为复杂且劳动强度大。目的：我们旨在为胃肠病学家，肝病学家，内科医师和医院医生提供有关终末期肝病相关并发症住院患者护理方法的综述。方法：西奈山医学中心的住院肝服务已为肝硬化患者开发了一种综合团队方法，并且多年来，这些培训了进修生和医务室工作人员有关治疗住院肝硬化患者的治疗原则和“明珠”。我们回顾了文献并就末期肝病并发症的处理提供了建议。此外，我们提供了我们机构在肝硬化患者护理中使用的治疗方案的综述。结果：晚期肝病的主要并发症包括感染，腹水，自发性细菌性腹膜炎，肝性脑病，门静脉高压症，曲张静脉出血，肝肾综合征和肝细胞癌。这些并发症的管理涉及选择适当的诊断研究并及时进行治疗。结论：肝硬化有许多并发症。这些并发症的管理可能很复杂，并且旨在稳定患者的临床状况。肝移植仍然是唯一的确定性治疗。

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《Digestive Diseases and Sciences》 |2011年第5期|共16页
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Perumalswami PV; Schiano TD;
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1. The management of hospitalized patients with cirrhosis: the Mount Sinai experience and a guide for hospitalists. [J] . Perumalswami PV, Schiano TD Digestive Diseases and Sciences . 2011,第5期

机译：住院肝硬化患者的管理：西奈山的经验和住院医生指南。
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6. Assessment and Management of Nutrition Status in the Hospitalized Patient With Cirrhosis [O] . Christopher Moore, Adam C. Stein 2018

机译：住院肝硬化患者营养状况的评估与管理
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机译：在使用新的扩张型心肌病的患者缓和EPOSTERS1385Longitudinal应变评估加速DENSE sequence1407Simultaneous T1和T2与CABIRIA心脏定量：在4维流动的加速算法初始临床experience1423Head对头比较CMR1502Left心室功能和尺寸由混合心脏正电子发射断层摄影术评价 - 磁性共振：由两个modalities1510Left庭派生左室射血分数和心室体积的个体间的比较，在1.5和3特斯拉评估心血管磁共振 - 免费的年龄和性别effects1514Comparison呼吸心脏MRI径向技术标准的多屏气电影SSFP CMR技术的LV卷和Function1536Self-导航自由呼吸各向同性3D整个心脏相位敏感反转恢复磁共振导航仪没有检测右Ventricu心肌infarction1547Assessment的评估拉尔菌株使用心肌变形恢复半自动技术：初步经验和正常Values1586Tissue跟踪心肌变形分析和预测左室重构急性心肌infarction1589Investigating策略优化31P MRS临床心脏在3T：初始Results1620Quantitative标准的先天缺失的诊断心包心脏磁Resonance1632Widespread组织损伤急性心肌梗死时：证据先进CMR relaxometry1322Computed CT冠状动脉成像与压力心脏磁共振对症的管理吻合血管患者：成本效益研究（战略研究）1339Comparison低与高剂量钆布醇在1.5特斯拉晚钆增强成像的临床可行性，在中间型地贫心脏并发症的预测study1347Multi参数心脏核磁共振的前瞻性德穆尔心血管磁共振的ticenter Study1461Prognostic价值衍生心肌纤维化指标在住院的急性期CMR的心脏移植recipients1523The作用：改变基于CMR-paradigms1542Preoperative比分预测缺血性心脏衰竭patients1555Excellent响应速度外科左心室重建心脏再同步化后心室反应治疗与磁共振imaging1626The ECG导引作为心脏磁共振成像致心律失常性基板的在ST段抬高心肌infarction1340Pathological在风险评估经历在3.0T CMR T1映射的室性早搏contractions1649Comparison和血管造影APPROACH分数区域消融患者的预测左束支传导疾病的患者与非缺血性心肌病相关因素：心血管磁共振study1342Myocardial重塑和纤维化nonischaemic扩张型心肌病：在从在由心血管磁性resonance1622Persistent心肌炎症评估肥厚型心肌病的纤维化和收缩功能障碍之间心血管磁性resonance1411The协会由于心肌内出血景点在再灌注STEMI为先导，以不利的LV重塑 - 从低的多参数mapping1566Semiquantitative分析和高的b值DWI的见解为在心脏MRI检测冠状动脉疾病急性myocarditis1567Value在结节性硬化症complex1578Papillary肌肉初诊收缩期Dysfunction1570Usefulness心脏磁共振检测心肌水肿提供进一步的深入了解肥大心脏：心血管磁共振study1627Diagnostic和CMR定时的临床意义（早期与晚）患者肌钙蛋白阳性的急性冠脉综合征和通畅的冠状动脉：表1。

The management of hospitalized patients with cirrhosis: the Mount Sinai experience and a guide for hospitalists.

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