Follow-Up and Community Care of the Child With a Chronic Disease

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DOI :10.26650/B/CH32.2024.010.016   IUP :10.26650/B/CH32.2024.010.016    Full Text (PDF)

Follow-up and Community Care of the Child with Chronic Liver Disease

Zerrin Önal, Özlem Durmaz

Chronic liver disease is characterized by irreversible changes in liver parenchyma accompanied by progressive damage and regeneration resulting in fibrosis and possible cirrhosis. Chronic liver disease is an important cause of morbidity and mortality in childhood. Therefore, its prognosis and treatment depend on the diagnosis of the underlying disease including potentially treatable or incurable diseases. Management is aimed at preventing or slowing down the progression of liver disease. Pediatric chronic liver disease involves a wide range of medical and psychosocial challenges for the healthcare team. Portal hypertension-related complications and those caused by malnutrition are common. Nutritional problems directly affect mortality and morbidity in children with end-stage liver disease. The pathophysiology of malnutrition is multifactorial and, if not managed efficiently, worsens longterm outcomes and survival before and after liver transplantation. Vaccination status should be reviewed carefully, and healthcare should be provided in the optimal clinical setting, to optimize outcomes and ensure high-quality pediatric care. Issues associated with chronic liver disease lead to difficulty in patient compliance to the treatment, as well as disease progression and decrease in the life quality of patients and their parents. Since possible medical and psychosocial complications associated with chronic liver disease directly affect survival and quality of life, timely prediction, prevention, and control is very crucial. To achieve this, a multidisciplinary approach is ideal.


Keywords: Pediatric patients, chronic liver disease, complication, management, follow-up
DOI :10.26650/B/CH32.2024.010.016   IUP :10.26650/B/CH32.2024.010.016    Full Text (PDF)

Kroni̇k Karaci̇ğer Hastalığı Olan Çocuğun İzlemi̇ ve Toplumda Bakımı

Zerrin Önal, Özlem Durmaz

Kronik karaciğer hastalığı, karaciğer parankiminde ilerleyici hasar ve rejenerasyon sonucunda fibrozis gelişmesi ile geri dönüşümü olmayan değişikliklerin oluştuğu ve sonuçta sirozun ortaya çıkabildiği bir süreçtir. Çocukluk yaş grubunda önemli morbidite ve mortalite nedenleri arasında yer almaktadır. Prognozu ve tedavisi, hastalığın etiyolojisine bağlıdır. Etiyoloji tedavi edilebilir olanların yanı sıra potansiyel olarak tedavi edilebilir veya tedavi edilemez hastalıkları içerir. Hedef ilerleyici karaciğerin hastalığının önlenmesi veya ilerleme hızının yavaşlatılmasıdır. Çocuklarda kronik karaciğer hastalığı, sağlık hizmeti veren ekip için zorlu bir dizi tıbbi ve psikososyal sorunu içerir. Kronik karaciğer hastalığı olan çocuklarda en sık portal hipertansiyon ve /veya malnütrisyonun oluşturduğu komplikasyonlar gözlenir. Son dönem karaciğer hastalığı olan çocuklarda özellikle beslenme sorunları mortalite ve morbiditeyi doğrudan etkiler. Malnütrisyon fizyopatolojisi multifaktöriyeldir. Etkili bir şekilde yönetilmezse, bu durum karaciğer nakli öncesi sonrasında geç dönem sonuçları ve sağ kalımı önemli ölçüde etkiler. Optimal sonuçlara ulaşmak ve yüksek kaliteli pediatrik sağlık bakımı sağlamak için aşılama durumuna ve sağlık hizmetinin verildiği klinik ortama dikkat edilmesi elzemdir. Kronik hastalığın getirdiği sorunlar, çocuklarda ve ebeveynlerde yaşam kalitesinde bozulma ve azalmayla birlikte tedaviye uyum zorluğunu da beraberinde getirir. Kronik karaciğer hastalığına bağlı gelişebilecek tibbi ve psikososyal komplikasyonlar sağ kalımı ve yaşam kalitesini doğrudan etkileyeceğinden bunların ön görülmesi, önlenmesi ve kontrol edilmesi çok önemlidir. Bunun için kronik karaciğer hastalığı olan çocuğun yönetiminde multidisipliner bir yaklaşım uygulanmalıdır.


Keywords: Çocuk, kronik karaciğer hastalığı, komplikasyon, yönetim, izlem

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