Cirrosis hepática : complicaciones clínicoquirúrgicas en pacientes mayores de 30 años, estudio a realizarse en el Area de Medicina Interna del Hospital Dr. Abel Gilbert Pontón, período 2014-2015
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2016
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Carrera de Medicina
Resumen
El presente trabajo de investigación tiene por objetivo determinar las principales complicaciones de la cirrosis hepática, la cual es una causa de morbimortalidad importante en nuestro país. Para ello se realizó un estudio descriptivo, retrospectivo, de corte transversal, de pacientes ingresados con diagnóstico de cirrosis hepática en el hospital Dr. Abel Gilbert Pontón.
Los datos fueron obtenidos de historias clínicas de pacientes hospitalizados, de los cuales se tomó un universo de 170 pacientes con diagnóstico de cirrosis hepática, basándose en una muestra de 109 casos que presentaron complicaciones.
Se encontró que el grupo etario que con mayor frecuencia presentaba cirrosis hepática son aquellos comprendidos en edades entre 50-70 años, con predominio del sexo masculino (69%). La causa más frecuente de cirrosis hepática fue la ingesta de alcohol con un 93% seguido en frecuencia de Hepatitis por infección con el virus de la hepatitis C correspondiente al 3%. La complicación más frecuente en nuestro medio fue la Ascitis con un 48%. Otras de las complicaciones halladas fueron: hemorragia digestiva alta por várices esofágicas con un 32%; la peritonitis bacteriana espontánea presente en el 13% de los casos, encefalopatía hepática en un 8%; el síndrome hepatorrenal con el 1%. En cuanto a los estadíos según la clasificación de Child-Pugh se determinó que el 58% de pacientes presentaron estadío C; el 35% estadío B y el restante 7% estadío A. En conclusión la cirrosis hepática en una enfermedad de adultos jóvenes, quienes tienen en su mayoría el antecedente de ingesta de alcohol. Muchos de los casos se diagnosticaron al momento de presentar complicaciones, lo cual se confirmó por medio de datos de laboratorio y de imágenes con ayuda de ecografía. Pudimos observar que no siempre es necesario el estudio histopatológico para poder llegar al diagnóstico de dicha enfermedad. Y por último que la mortalidad fue de un 20%.
This research aims to determine the main complications of liver cirrhosis, which is a cause of significant morbidity and mortality in our country. A descriptive, retrospective, crosssectional, of patients admitted with a diagnosis of liver cirrhosis in the hospital Dr. Abel Gilbert Ponton was performed. Data were obtained from medical records of hospitalized patients, of whom a universe of 170 patients diagnosed with liver cirrhosis was made, based on a sample of 109 cases had complications. It was found that the age group most often presented liver cirrhosis are included in those aged 50-70 years , predominantly male ( 69%). The most common cause of liver cirrhosis was alcohol intake with 93 %, followed in frequency by infection with hepatitis virus hepatitis C corresponding to 3%. The most common complication in our Ascites was 48% . Other complications found were: upper gastrointestinal bleeding esophageal varices with 32% ; spontaneous bacterial peritonitis present in 13% of cases , hepatic encephalopathy 8% ; hepatorenal syndrome with 1% . As for the stages according to the Child-Pugh classification it was determined that 58 % of patients had stage C ; 35% stage B and the remaining 7 % instar A. In conclusion liver cirrhosis a disease of young adults, mostly those with a history of alcohol intake. Many of the cases were diagnosed when complications, which was confirmed by laboratory data and imaging using ultrasound. We observed that the histopathology is not always necessary to make the diagnosis of the disease. And finally that the mortality was 20%.
This research aims to determine the main complications of liver cirrhosis, which is a cause of significant morbidity and mortality in our country. A descriptive, retrospective, crosssectional, of patients admitted with a diagnosis of liver cirrhosis in the hospital Dr. Abel Gilbert Ponton was performed. Data were obtained from medical records of hospitalized patients, of whom a universe of 170 patients diagnosed with liver cirrhosis was made, based on a sample of 109 cases had complications. It was found that the age group most often presented liver cirrhosis are included in those aged 50-70 years , predominantly male ( 69%). The most common cause of liver cirrhosis was alcohol intake with 93 %, followed in frequency by infection with hepatitis virus hepatitis C corresponding to 3%. The most common complication in our Ascites was 48% . Other complications found were: upper gastrointestinal bleeding esophageal varices with 32% ; spontaneous bacterial peritonitis present in 13% of cases , hepatic encephalopathy 8% ; hepatorenal syndrome with 1% . As for the stages according to the Child-Pugh classification it was determined that 58 % of patients had stage C ; 35% stage B and the remaining 7 % instar A. In conclusion liver cirrhosis a disease of young adults, mostly those with a history of alcohol intake. Many of the cases were diagnosed when complications, which was confirmed by laboratory data and imaging using ultrasound. We observed that the histopathology is not always necessary to make the diagnosis of the disease. And finally that the mortality was 20%.
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Cirrosis hepática, Indicadores de morbimortalidad, Hospital de Especialidades Guayaquil Dr. Abel Gilbert Pontón, Cantón Guayaquil, Ecuador, Complicaciones, Registros médicos