第四篇 第十四章 肝硬化（Chapter 14 cirrhosis of the liver）.doc

第四篇 第十四章 肝硬化（Chapter 14 cirrhosis of the liver） Set the righteous * is a chronic, progressive liver disease characterized by diffuse fibrosis, pseudo lobule and regeneration nodules, which are commonly caused by different causes * multisystem is affected by liver function damage and portal hypertension * severe complications such as gastrointestinal bleeding, hepatic encephalopathy, secondary infection, etc * the liver only has fibrous tissue hyperplasia or only hepatic cell nodular hyperplasia can not be called cirrhosis. Such as congenital hepatic fibrosis and focal nodulous hepatic cell proliferation Etiology and pathogenesis * viral hepatitis * alcoholism: 80g/d, 10 years * schistosomiasis * cholestasis * circulatory disorder * industrial poisons, drugs * nutritional disorders * metabolic disorder Blood disease Hepatic bean - like nuclear degeneration Alpha-1 antitrypsin deficiency * immune disorder Autoimmune hepatitis * unknown cause Non-alcoholic fatty hepatitis A variety of reasons Liver cells diffuse transsexual necrosis, liver lobular fibrous scaffold collapse fibrous tissue hyperplasia, hepatic cell nodular regeneration Damage and repair alternate Liver lobular structure reconstruction, liver blood circulation reconstruction, liver deformation, hardening Portal hypertension and hepatic insufficiency Disease management * small tuberous cirrhosis The diameter is more than 3 ~ 5 mm, not exceeding 1 cm, most commonly * large tuberous cirrhosis. The diameter is 10 ~ 30 mm, the maximum is 50 mm * mixed cirrhosis of the size of tuberosity Nodular mixture * schistosomiasis liver fibrosis Pathological changes of liver cirrhosis * cirrhosis of the liver * portal hypertension and collateral circulation open * enlargement of the spleen * portal hypertension gastropathy and bowel disease * hepatic pulmonary syndrome * testis or ovaries, thyroid, adrenal cortical atrophy Clinical manifestations of * the clinical manifestations are diverse, the disease is often hidden,