4 therapeutic of hepatitis B are reminded

4 therapeutic of hepatitis B are reminded
It is very complicated for professor of Ningbo university affiliated hospital of medical college Wang De to assess virus situations of the infeted of chronic hepatitis B in an all-round way before being raised and does not forget to treat, go from different persons who carry to the chronic hepatitis of weight, to compensate one or lose and compensate liver cirrhosis and even HCC (hepatocarcinoma) ,Healing solutions are different, all need one to examine a doctor to ponder deeply, and fully communicate with the patient. But in the clinical practice, the importance which a lot of doctors assess before often ignoring and treating, have not used the sufficient time and energy to pay attention to and find out about the client's infection history, all sorts of actual conditions of condition and patient, but the light, according to meeting the card or personal view, begin the antiviral treatment easily, so that it is difficult for the result to reach satisfactory curative effect, even cause and treat to fail. In 2009 the new European guide point out and assess the content clearly: 1. Severity of the condition. 2.HBVDNA state amount. 3.Overlap infects and the other causes of disease. 4.Meaning in which the liver lives and examines. As to patient of our country, will notice the genotype (if there are conditions) , mother-to-baby transmission, economic situation, the intersection of medicines and price, medical insurance pay, comply with and special requirement ' Pregnant) Wait for and pay considering synthetically, and hold and manage the scheme for the first time cautiously on the basis of fully respecting patient's will. Often see different hospitals or different experts or doctors of the same hospital, there is healing solution completely contradicting on the same patient. This all results from the reason that the shortage is assessed completely. Need, insist individual treat the whole world generally acknowledge and write guide into, recommend used for treating in norm to resist the intersection of HBV and medicine, have two 7 kinds at present still. According to the Asian-Pacific guide of 2008 new editions, interferon and nucleoside (acid) Any kind of medicine in the analog is a gleam of treatment medicine. We should be according to the characteristic of different medicines and actual conditions of different patients, chosen the most appropriate medicine healing solution. For example a non- gravidic woman can select interferon for use preferably pregnant age ' Among them conditional recommendation uses and gathers interferon of ethylene glycol) ,Because its course of treatment shorter ' In one year) . HBeAg positive chronic hepatitis B, such as the prior choice in order to make more than the, probably realize comparatively fast pair is up to standard (HBVDNA inhibits, HBe serology changed) ; The intersection of HBeAg and negative chronic hepatitis B, until the intersection of prior choice and kindness, for the intersection of card and Wei, have, ensure (potent to inhibit virus from and not most low to able to bear medicines) while being double ,Help the more long-term security treatment; Low year patient, HBV of quantity, can also select the intersection of A and Wei, good fortune of Germany, for use, suitable for, treat for a long time relatively. The patient who enjoys medical insurance, can still rest assured to employ Lammi the treats definitely, first, the 10 -year long test of its validity process, have already changed a generation of patients' destiny. Second, being able to bear medicines can be predicted ahead of time, and can find, adopt and rescue and treat in time in early days. Treat the street map and is remembered well to be in employing on the heart, hold three time points which treat the street map: 3 months - -Judge curative effect tentatively, exclude from, take place, treat, fail patient originally, reduce medicine, waste while being unnecessary. 6 months - -It is able to bear the medicine protective screen medicine (LAM, Ldt) to assess the low gene Curative effect, select some virus and reply the case, adjust the healing solution (add medicines or change dressings) in time . 12 months - -It is able to bear the medicine protective screen medicine and able to bear the relatively late medicine (ETVADV, TNV) of medicine to assess the high gene Curative effect, select some virus and reply the case, adjust the healing solution (add medicines or change dressings) in time . The society employs " 4P" Mode Doctors and patients both sides should set up one together " Management of the whole course of disease " Consciousness,actively advocate sum give a recommendation "4P " Mode. 4P means preventive ' Preventative) , predictive (predicting) , presonalized (individual) With participatory (the property of participation) . This is a modern medical management new mode, have reflected that moves towards cultural and educational care from technology the highestly. " 4P " recently Have already been applied to and resist, and strive for the early and effective virus and inhibit and realize HBeAg serum is changed, can prevent liver cirrhosis and hepatocarcinoma from taking place ( preventatively) . To managing the target for the first time, brief the street map on, exclude from selecting medicine not to fit for the case (take place and treat to fail originally) in time ,HBVDNA can not be measured in 24 weeks, more chances realize DNA will be measured and can not change with HBeAg serology (predicting) . Choose, suitable for demand their and reach healing solution to treat the goal most possibly most for different target as much as possible ' The individual treats) . Doctor and patient need to carry on the sufficient and effective communication, in order to ensure the good complying with, make success against virus treatment ' Property of participation) . Among them it is important and urgent that the property of participation shows under the present medical environment even more.

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