Métodos de detecção de fibrose em pacientes cirróticos: revisão sistemática
Methods of fibrose detection in cirrochemical patients: systematic review
Thaís Sant’Ana Soares Silva, , Poliana da Silva Oliveira, , Riellen Vilanova Feitosa, , Rafael de Azevedo Silva, , Ana Paula de Santos Oliveira Brito, , Hamilton Cezar Rocha Garcia
Resumo
Objetivo: Este estudo objetivou realizar uma revisão sistemática de artigos publicados em inglês, espanhol e português na última década, visando a pesquisa sobre métodos de detecção de fibrose em pacientes cirróticos. Método: Foram selecionados estudos publicados em 2013 a 2018. Os descritores utilizados foram de “Cirrose Hepática”, “Diagnóstico” e “Hepatopatias”. As bases de dados consultadas foram MedLine, do SciELO, do Lilacs e do Science Direct. Resultados: Em 13 artigos, houve um aumento do interesse acerca desse tema na literatura, sobretudo no que tange a publicações acerca das vantagens e desvantagens dos métodos diagnósticos. Foram encontrados 4 artigos pesquisando o método invasivo (biópsia hepática), enquanto 9 artigos analisaram métodos não invasivos sendo que destes 9 citaram métodos de imagem e 4 citaram métodos séricos. Conclusão: Apesar dos grandes benefícios técnicos descritos na literatura, novas pesquisas devem ser realizadas afim de identificar métodos com melhor custo-efetividade e com mais precisão. Devido à amplitude de métodos, de seus níveis de fidelidade e de custo, foi possível relatar qual teria melhor custo-efetividade, sendo a ultrassonografia um exame de primeira linha. Os métodos séricos mostraram-se importantes para o monitoramento e apresentaram informações úteis de prognóstico dos pacientes. Ainda assim, a biópsia hepática é considerada o “padrão-ouro” dos métodos de diagnóstico de doenças hepáticas.
Palavras-chave
Abstract
Purpose: This study aimed to perform a systematic review of articles published in English, Spanish and Portuguese in the last decade, with a view to research on methods of fibrosis detection in cirrhotic patients. Methods: It was selected studies published from 2013 to 2018. The descriptors used were from ” Liver Cirrhosis “, “Diagnosis” and ” Liver Diseases”. The database bases consulted were MedLine, SciELO, Lilacs and Science Direct. Results: In 13 articles, there was an increase in interest about literature, above all not so many publications about different approaches and different diagnostic methods. Were found 4 articles researching about invasive method (hepatic biopsy), as many as 9 articles were cited non invasive methods, among these, 9 were cited imaging methods e 4 were cited serum methods. Conclusion: Despite the technical benefits described in the literature, new research must be carried out in order to identify methods that are more cost-effective and more accurate. Due to the breadth of methods, fidelity levels and cost, it was possible to report which would be most cost-effective, with ultrasound being a first-line examination. Serum methods were important for monitoring and provided useful patient prognostic information. Still, liver biopsy is considered the “gold standard” of methods for diagnosing liver disease.
Keywords
Referências
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