• Title/Summary/Keyword: cirrhosis

검색결과 639건 처리시간 0.19초

환자표본자료를 이용한 간경변증 환자의 의료이용 특성 및 의료비용 분석 (Analysis of Medical Use and Costs Related to the Management of Liver Cirrhosis Using National Patients Sample Data)

  • 김혜린;박재아;신지영;박승후;이의경
    • 한국임상약학회지
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    • 제26권4호
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    • pp.341-347
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    • 2016
  • Background: Liver cirrhosis causes substantial socio-economic burden and is one of the major severe liver diseases in Korea. Nonetheless, there is only a few studies that analyzes disease burden of liver cirrhosis in Korea. Such study must be carried out due to its increasing need from the invention of new drugs for chronic hepatitis and demand for cost-effectiveness analyses. Methods: Patient sample data with ensured representativeness was analyzed retrospectively to compare the medical costs and uses for patients with compensated cirrhosis and decompensated cirrhosis. Patient claims data that include K74 and K703 from the year of 2014 were selected. Within the selected data, decompensated cirrhosis patient was identified if complications such as ascites (R18), encephalopathy (B190), hepatic failure (K72), peritonitis (K65), or esophageal varices (I85) were included, and they were compared to compensated cirrhosis patients. Results: 6,565 patients were included in the analysis. The average cost per patient was 6,471,020 (SD 8,848,899) KRW and 2,173,203 (4,220,942) KRW for decompensated cirrhosis and compensated cirrhosis, respectively. For inpatients, the average hospitalized days was 38.0 (56.4) days and 27.2 (57.2) days for decompensated cirrhosis and compensated cirrhosis, respectively. For outpatients, the average number of visits was 8.7 (9.1) days and 5.3 (7.5) days for compensated cirrhosis and decompensated cirrhosis, respectively. Conclusion: Compared to compensated cirrhosis patients, decompensated cirrhosis patients had higher costs, especially for hospitalization, injection, examination, and drugs administrated within medical institutions.

Is partial hepatectomy a curable treatment option for hepatocellular carcinoma accompanied by cirrhosis? A meta-analysis and cure model analysis

  • Byungje Bae;Keera Kang;Sung Kyu Song;Chul-Woon Chung;Yongkeun Park
    • 한국간담췌외과학회지
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    • 제26권1호
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    • pp.47-57
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    • 2022
  • Backgrounds/Aims: It is challenging to assess the efficacy of partial hepatectomy (PH) as a treatment option for patients with hepatocellular carcinoma (HCC) accompanied by cirrhosis. This study aimed to determine the cure fraction of PH for HCC accompanied by cirrhosis compared to that for HCC without cirrhosis. Methods: A systematic review was performed on outcomes of previous studies that compared recurrence-free survival (RFS) after PH in patients with HCC with or without cirrhosis. A meta-analysis was conducted to obtain the cumulative hazard ratio for two patient groups: cirrhosis and non-cirrhosis. Cure fractions after PH in both groups were determined using a cure model analysis. Results: A total of 18 studies were eligible for meta-analysis and 13 studies were selected for the cure model analysis. The cumulative hazard ratio for RFS of the cirrhosis group compared to that of the non-cirrhosis group was 1.66 (95% confidence interval [CI], 1.43-1.93). Survival data of 3,512 patients in both groups were reconstructed from survival curves of original articles for cure model analysis. The probability of being statistically cured after PH for HCC was 14.1% (95% CI, 10.6%-18.1%) in the cirrhosis group lower than that (32.5%) in the non-cirrhosis group (95% CI, 28.6%-36.4%). Conclusions: The prognosis after PH for HCC accompanied by cirrhosis is inferior to that for HCC without cirrhosis. However, a cure can be expected for one-seventh of patients with HCC accompanied by cirrhosis after PH.

Safety of endoscopic retrograde cholangiopancreatography (ERCP) in cirrhosis compared to non-cirrhosis and effect of Child-Pugh score on post-ERCP complications: a systematic review and meta-analysis

  • Zahid Ijaz Tarar;Umer Farooq;Mustafa Gandhi;Saad Saleem;Ebubekir Daglilar
    • Clinical Endoscopy
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    • 제56권5호
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    • pp.578-589
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    • 2023
  • Background/Aims: The safety of endoscopic retrograde cholangiopancreatography (ERCP) in hepatic cirrhosis and the impact of Child-Pugh class on post-ERCP complications need to be better studied. We investigated the post-ERCP complication rates in patients with cirrhosis compared with those without cirrhosis. Methods: We conducted a literature search of relevant databases to identify studies that reported post-ERCP complications in patients with hepatic cirrhosis. Results: Twenty-four studies comprising 28,201 patients were included. The pooled incidence of post-ERCP complications in cirrhosis was 15.5% (95% confidence interval [CI], 11.8%-19.2%; I2=96.2%), with an individual pooled incidence of pancreatitis 5.1% (95% CI, 3.1%-7.2%; I2=91.5%), bleeding 3.6% (95% CI, 2.8%-4.5%; I2=67.5%), cholangitis 2.9% (95% CI, 1.9%-3.8%; I2=83.4%), and perforation 0.3% (95% CI, 0.1%-0.5%; I2=3.7%). Patients with cirrhosis had a greater risk of post-ERCP complications (risk ratio [RR], 1.41; 95% CI, 1.16-1.71; I2=56.3%). The risk of individual odds of adverse events between cirrhosis and non-cirrhosis was as follows: pancreatitis (RR, 1.25; 95% CI, 1.06-1.48; I2=24.8%), bleeding (RR, 1.94; 95% CI, 1.59-2.37; I2=0%), cholangitis (RR, 1.15; 95% CI, 0.77-1.70; I2=12%), and perforation (RR, 1.20; 95% CI, 0.59-2.43; I2=0%). Conclusions: Cirrhosis is associated with an increased risk of post-ERCP pancreatitis, bleeding, and cholangitis.

Efficacy, immunogenicity, and safety of COVID-19 vaccines in individuals with liver cirrhosis: a rapid review and meta-analysis

  • Faranak Salajegheh;Mohammad Rezaei Zadeh Rukerd;Mohsen Nakhaie;Zohreh-Al-Sadat Ghoreshi;Javad Charostad;Nasir Arefinia
    • Clinical and Experimental Vaccine Research
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    • 제13권2호
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    • pp.83-90
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    • 2024
  • The emergence of coronavirus disease 2019 (COVID-19) vaccines has been a remarkable advancement. However, the efficacy, immunogenicity, and safety of these vaccines in individuals with liver cirrhosis require careful evaluation due to their compromised immune status and potential interactions with underlying liver disease. The present study aimed to evaluate the safety and efficacy of COVID-19 vaccines in liver cirrhosis patients. In the present study, we searched international databases, including Google Scholar, PubMed, Scopus, Embase, and Web of Science. The search strategy was carried out by using keywords and MeSH (Medical Subject Headings) terms. STATA ver. 15.0 (Stata Corp., USA) was used to analyze the data statistically. The analysis was performed using the randomeffects model. We also used the chi-square test and I2 index to calculate heterogeneity among studies. For evaluating publication bias, Begg's funnel plots and Egger's tests were used. A total of 4,831 liver cirrhosis patients with COVID-19 were examined from 11 studies. The rate of hospitalization in the patients with liver cirrhosis was 17.6% (95% confidence interval [CI], 9%-44%). The rate of fever in the patients with liver cirrhosis was 4.5% (95% CI, 0.9%-8.1%). The rate of positive neutralizing antibodies in the patients with liver cirrhosis was 82.5% (95% CI, 69.8%-95.1%). Also, the rates of seroconversion after the second vaccination in patients with liver cirrhosis and the control group were 96.6% (95% CI, 92.0%-99.0%), and 99.7% (95% CI, 99.0%-100.0%), respectively. COVID-19 vaccines have demonstrated promising efficacy, immunogenicity, and safety profiles in individuals with liver cirrhosis, providing crucial protection against COVID-19-related complications.

간경변으로 입원한 환자 33례에 대한 분석 (The Clinical Study on 33 Cases of Liver Cirrhosis)

  • 최서형;심민;김태수;민지연;최영규
    • 대한한방내과학회지
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    • 제26권4호
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    • pp.836-843
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    • 2005
  • Objective : Liver cirrhosis is a disease of the liver in which normal cells are replated by scar tissue. Chronic liver disease and liver cirrhosis are the foutth ranked causes of death in Korea. However, clinical data on liver cirrhosis is not accumulated in oriental medicine. Therefore, clinical characteristics of 33 liver patients admitted to Hana Oriental Hospital from May 2004 to May 2005 were studied. Methods : Clinical characteristics of liver cirrhosis, such sex, age, causes, Child-Pugh class, chief complain, abdomen ultrasonography, disease duration, past history, blood test and urinalysis were reviewed. Results : The results of this study were as follows: 1 The distribution of sex and age in our study is similar to already reported statistics. 2. Hepatitis B and alcohol are the major factors to cause the liver cirrhosis. Diabetes and hypertention contribute more to cause than they have in previous histories. 3. Major symptoms are following: fatigue 87.9%, ascites 84.8%, jaundice 78.8%, leg edema 72.7%, dyspepsia 45.5%. 4. Most liver cirrhosis patients have pancytopenia. Standard Deviation accentuates the big differences between total bilirubin and serum amonia. 5. In urinalysis, Urobilinogen 19 patients (57.6%), bilirubin 12 patients (36.4%), blood 15 patients (45.5%) are positive. 11 cases of 15 in blood positive results scored $3{\sim}4+$. Contusions : In oriental medicine, it will be necessary to research and develop oriental medical therapies for liver disease including liver cirrhosis.

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만성 B형 간염을 동반한 초기 간경변 환자에서 인진청간탕(茵蔯淸肝湯) 투여 관찰한 5례 (Five Cases of Patients Treated with Injinchunggan-tang for Liver Cirrhosis and Chronic Hepatitis B)

  • 이장훈;김세훈;김철우;이지은;김영철;우홍정;정윤종
    • 대한한방내과학회지
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    • 제27권4호
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    • pp.1014-1026
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    • 2006
  • Liver cirrhosis is a liverdisease in which the normal microcirculation, the gross vascular anatomy, and the hepatic architecture have been variably destroyed and altered with fibrous septa surrounding regenerated or regenerating parenchymal nodules. Liver cirrhosis is regarded as a serious health problem with high prevalence in the world as well as in Korea. Liver cirrhosis is an irreversible disease. However, in cases of liver cirrhosis induced by chronic hepatitis B, we should treat the chronic hepatitis B, because it frequently progresses to cirrhosis and hepatoma. We observedimprovements of symptoms and laboratory tests with herb medicine Injinchunggan-tang (茵蔯淸肝湯) in five cases ofliver cirrhosis and chronic hepatitis B. The serum aminotransferase was preserved within normal value levels for a long time, 3 years to 7 years. However, further study is necessary to determine the effect of herb medicine on liver cirrhosis and chronic hepatitis B.

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간경변증 환자의 경험 (The Experience of Patients with Liver Cirrhosis)

  • 김분한;김윤숙;김혜란;전미선;권미형
    • 성인간호학회지
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    • 제16권4호
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    • pp.608-616
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    • 2004
  • Purpose: The aim of this study was to identify the experience of patients with liver cirrhosis. Method: This study was performed from march 2003 to June 2003. The participators were five men. Data collected through in-depth personal interviews, which were recorded and analysed according to the Colazzi's method. Result: Liver cirrhosis was classified into 20 themes, 70 formulated meaning, and 10 categories. The Result confirmed that the experience of liver cirrhosis patients were classified into 10 categories; unexpected change, limited daily living and role, difficult compliance with therapeutic regimen, unbelief so untreated with apathy, negative emotional change, lack of cause perception, self control, perceived family support, expectations for recovery and healing. Conclusion: We, cooperative researchers, realized that to reduce not only the days of hospital treatment and the economic loss, as well as the expenditure of insurance the importance of managing liver cirrhosis from early diagnosis and the physical, spiritual, social role in studying the patients who experience liver cirrhosis.

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간경변증 환자의 건강관련 삶의 질 모형구축 (Construction of Model for Health-related Quality of Life of Liver Cirrhosis Patients)

  • 김지숙;홍해숙
    • Journal of Korean Biological Nursing Science
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    • 제16권4호
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    • pp.292-299
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    • 2014
  • Purpose: This is a study on the structural model that aims to build a path model of multivariates affecting the quality of health-related living for liver cirrhosis patients and specify causal relations affecting the quality of health-related living for liver cirrhosis patients. Methods: The research was conducted on 244 patients diagnosed with liver cirrhosis and the data were collected from July 2013 to January 2014. The collected data were analyzed using IBM SPSS 19.0 and AMOS 21.0 statistical programs. Results: All the fit indexes of the path model properly met the assessment criteria. Anxiety, depression, functional status, and perceived health directly affected the quality of health-related living for liver cirrhosis patients and anxiety, depression, and functional status directly affected perceived health. Social support, anxiety, and depression directly affected the functional status. Conclusion: It is necessary to segment the severity of liver cirrhosis in testing its direct and indirect effects on the quality of health-related living for patients with the condition.

동맥혈화지표 (Arterialization Index)를 이용한 간경화증의 혈류측정 (Dynamic Hepatic Blood Flow Scan of Liver Cirrhosis by Arterialization Index)

  • 김일영;유형식;이종태;박창윤
    • 대한핵의학회지
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    • 제17권2호
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    • pp.19-24
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    • 1983
  • The purpose of this study was to develop a method by which the sensitivity of radionuclide liver imaging for detection of liver cirrhosis could be enhanced. Dynamic blood flow scan were performed 21 cases of liver cirrhosis patients by using computerized gamma camera named arterialization index. The results were as follows: 1) Arterialization index were higher in liver cirrhosis comparing to normal value 0.33 and its mean is 2. 02. 2) Comparing to static liver scan, higher sensitivity in dynamic hepatic blood flow scan for detection of liver cirrhosis. Sensitivity for detection of liver cirrhosis is over 90%. 3) There are no correlation between arterialization index and serum albumin level. The use of hepatic dynamic blood flow scan proved effective in detection of liver cirrhosis. However, the test may be used as an aid in distinguishing between normal and pathologic livers.

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간경변증환자의 환자역할행위에 관한 연구 (A Study on Liver Cirrhosis Patients행 Sick Role Behavior)

  • 김옥수
    • 대한간호학회지
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    • 제15권1호
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    • pp.30-43
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    • 1985
  • Liver cirrhosis is the common cause of death in Korea today. But, if liver cirrhosis Patients were treated in the early stage of the disease Process, they can have a chance to carry their daily lives with prescribed medical and nursing regimens. Each patient has different health beliefs that there is a different Sick Role Behavior in the process of treatment. In order to increase and control the desired patient's Sick Role Behavior, it is important for nurses to understand the health beliefs influencing Sick Role Behavior. The purpose of this study was to determine factors influencing Sick Role Behavior and provide objective and scientific data to health education, treatment and nursing care. The subjects for this study were 80 Liver Cirrhosis patients selected from in and out patients of the medical department of four University Hospitals in Seoul, Won Joo and Mok Po city. Data was collected from Sep. 18, to Oct. 15, 1984. The measurement tool was the questionaire that developed by the investigator from the literature review based on Health Belief Model. The data Collection was done by interview. Analysis of data was done by use Mean, S.D., ANOVA, Pearson Correlation Coefficient and Stepwise Multiple Regression. The result of study were as follows: 1. The significant influencing variables on the Liver Cirrhosis Patient's Sick Role Behavior in general characteristics were Sex, Marital Status, Educational levels, Family's income and Duration after diagnosis. 2. Between the Sick Role Behavior and Health Belief Model, a) The first hypothesis that the stronger degree of Health Motivation, the higher degree of Liver Cirrhosis Patient's Sick Hole Behavior was supported (r=0.7892, p=0.0000). b) The second hypothesis that the higher degree of perceived susceptibility, the higher degree of Liver Cirrhosis Patients' Sick Role Behavior was supported (r=0.6383, p=0.0000) c) The third hypothesis that the higher degree of perceived severity, the higher degree of Liver Cirrhosis Patients' Sick Role Behavior was supported (r=0.5869, p=0.0000). d) The fourth hypothesis that the higher degree of perceived benefit, the higher degree of Liver Cirrhosis patient's Sick Role Behavior was supported (r=0.7535, p=0.0000). e) The fifth hypothesis that the lower degree of perceived barrier, the higher degree of Liver Cirrhosis Patient's Sick Role Behavior was supported(r=-9.7709, p=0.0000) f) The sixth hypothesis that the higher degree of knowledge in Disease, the higher degree of Liver Cirrhosis patients'lck Role Behavior was supported (r=0.7538, p=0.0000), g) In the correlation among variables, it was found positive correlation except that perceived barrier was negatively correlated. In the Stepwise Multiple Regression and Independent Variables, the factor“Health Motivation”could account for Sick Role Behavior in 62.28% of the Sample (F=128. 786, p<0.01). When the factor“perceived barrier”is added to this, it account for 70.38% of Sick Role Behavior (F=93.479, p <0.01) and the factor“knowledge in disease”is also included, it account for 74.78% of Sick Role Behavior (F=75.131, p <0.01). Finally, when the factor“perceived susceptibility”is included, it account for 75.03% of Sick Role Behavior (F=56.329, p <0.01).

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