| Abstract | CILJ ISTRAŽIVANJA: prikupiti i analizirati sve važne podatke o pacijentima koji su primljeni u bolnicu pod dijagnozom portalne encefalopatije. Analizirati terapijski pristup i usporediti ga sa suvremenim terapijskim principima.
MATERIJAL I METODE: izvršeno je retrospektivno istraživanje u kojoj su izdvojeni svi bolesnici koji su pod dijagnozom portalne encefalopatije primljeni na Kliniku za unutarnje bolesti, KBC Split u razdoblju od 1. siječnja 2010. godine do 31. prosinca 2014. godine. Obrađeni su podaci iz povijesti bolesti o dobi, spolu, etiologiji, laboratorijskim nalazima, liječenju te ishodu liječenja. Korišten je program Microsoft Excel za obradu podataka
REZULTATI: Od 2010. do 2014. hospitalizirano je 60 bolesnika preko hitnog internog prijema s dijagnozom portalne encefalopatije. Kod 78,33% pacijenata uzrok je bio alkohol, 5% ciroza je bilo kardiogene, a 8,33% infektivne etiologije. 35% ih je pri prijemu imalo ascites, 60% ikterus dok ih je 91,66% imalo neki od poremećaja svijesti. Laktuloza i antibiotici su lijekovi koji su ordinirani pacijentima u najvećem postotku (96,66%). Nakon njih dolaze razni oblici infuzija (81,66%), diuretici (73,33%) i inhibitori protonske pumpe (71,66%). Laktuloza nijednom nije korištena sama, nego uvijek u kombinaciji s drugim lijekovima. Srednja vrijednost pada amonijaka je iznosi 56,92, a medijan pada 43,32. Što se tiče CRP-a, srednja vrijednost pada iznosila je 21,25, a medijan pada 1,8. Preživjela su 43 pacijenta (71,67%), a kod njih 40 stanje se poboljšalo (93,02%). Kliničko stanje je ostalo nepromijenjeno kod trojice pacijenata. Pri otpustu, laktuloza je propisana kod 88,37% pacijenata, diuretici kod 69,76 % te inhibitori protonske pumpe kod 67,44 % pacijenata.
ZAKLJUČAK: Istraživanje je pokazalo da je liječenje provedeno suvremenim terapijskim principima koje je osim farmakoloških mjera (laktuloza, antibiotici i ostalo) uključivalo i opće dijetetske mjere (regulacija unosa proteina). Potrebno je i dalje poraditi na prevenciji ciroze i precipitirajućih faktora portalne encefalopatije, kao i na edukaciji pacijenata. |
| Abstract (english) | RESEARCH OBJECTIVE: Gathering and analysis of all relevant information about patients who were hospitalized with the diagnosis of portal encephalopathy. Analysis of the therapeutic measures and comparing them to the modern therapeutical principles.
MATERIAL AND METHODS: A retrospective study has been done in which all the patients who were admitted to Internal Clinic, Clinical Hospital Center Split from 1st of January, 2010 to 31st of December, 2014 with the diagnosis of portal encephalopathy, were segregated. Data from their files (gender, age, ethiology, laboratory results, treatment and the outcome) were analysed. Microsoft Excel was used for data analysis.
RESULTS: From 2010 to 2014, 60 patients were hospitalized with the diagnosis of portal encephalopathy. The cirrhosis was caused by alcohol in 78,33% cases, heart failure 5% and hepatitis in 8,33%. On the day of hospitalisation, 35% of the patients had ascites, 60% had jaundice and 91,66% had a disorder of consciousness. Lactulose and antibiotics were administered in the majority of patients (96,66%). Various intravenous infusions were administered in 81,66% of patients, diuretics 73,33% and proton pump inhibitors 71,66%. Lactulose was never administered alone, but always in the combination with other medications. Average drop of ammonia level was 56,92 and median 43,32. Average drop of CRP level was 21,25 and median 1,8. 43 patients survived (7,67%) and 40 of them had an improvement in their clinical status (93,02%). Clinical status in 3 patients remained unchanged. When being discharged from the hospital, lactulose was prescribed in 88,37% ,diuretics in 69,76% and proton pump inhibitors in 67,44% of patients.
CONCLUSION: Study showed that the treatment that was observed followed modern therapeutical principles. Besides pharmacological therapy (lactulose, antibiotics and other medications) it included general measures, especially dietary ones (protein intake regulation). It is still necessary to work on the prevention of cirrhosis, precipitating factors of portal encephalopathy and the education of patients. |
