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Clinical manifestations of liver cirrhosis

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Updated: Thursday, Mar 18,2010, 10:12:17 AM
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1, liver function compensatory stage
    Most patients can be asymptomatic or mild symptoms, often a lack of specificity. May have fatigue, anorexia, indigestion, nausea, vomiting, right upper abdominal symptoms such as pain and diarrhea. Among them, fatigue and loss of appetite early on, and the more prominent. Duocheng the symptoms of intermittent, due to fatigue or with disease emerged, after a rest after mitigation.
    Body conditions are generally no abnormal signs were not obvious, the liver is not swollen or slightly swollen, the Ministry of patients with splenomegaly, and may appear spiders hemorrhoids and liver palm. Liver function tests more than in the normal range or mildly abnormal.
    2, liver function decompensated
    Has obvious symptoms There are two major types: ① liver damage caused by the decrease of plasma albumin, edema, ascites, jaundice, hepatic encephalopathy, etc.; ② portal vein obstruction and high pressure generated by the formation of collateral circulation, include splenomegaly, hypersplenism, and ascites and so on.
    l, symptoms
    (1), loss of appetite, for the most common symptom, sometimes accompanied by nausea, vomiting, more due to gastrointestinal hyperemia, secretion and absorption of gastrointestinal dysfunction caused by the late formation of ascites, gastrointestinal bleeding and liver failure will become more serious .
    (2), weight loss, as the more common symptom, mainly due to loss of appetite, eating enough, gastrointestinal tract, digestion and absorption barriers, in vivo reduction in albumin synthesis.
    (3), fatigue fatigue, but also for one of the early symptoms, the extent of feeling tired from mild to severe fatigue, consistent with the activity level of liver disease. Produced weak reasons as follows: ① eating enough calories; ② carbohydrates, protein, fat and other metabolic intermediate barriers caused by lack of energy generated; ③ poor liver damage or biliary excretion, the blood cholinesterase decreased, affecting nerves muscle's normal physiological function; ④ lactic acid into glycogen obstacles to the process of occurring, muscle activity, excessive lactic acid accumulation.
    (4), diarrhea, quite prevalent, mostly controlled by the intestinal wall edema, intestinal malabsorption (in fat-based), nicotinic acid deficiency and parasitic infection of the factor of c
    (5), abdominal pain caused by inflammation around licensing reasons, the liver cells necrosis, inflammation around the liver, portal vein thrombosis and (or) the portal vein Yandeng. Abdominal pain in large nodular cirrhosis of the more prevalent, representing about 60% ~ 80%. More in the upper abdomen pain, and often episodic, and sometimes cramps in nature was. May also be associated with abdominal pain due to peptic ulcer, biliary tract disease, intestinal infections caused by. With abdominal pain and fever appeared at the same time, jaundice, and liver pain often associated with liver disease itself.
    (6), abdominal distention, is a common symptom, may a low clock hyperlipidemia, flatulence, ascites and hepatosplenomegaly due.
    (7), bleeding, liver dysfunction affect the prothrombin and other coagulation due to the synthesis of thrombocytopenia caused by hypersplenism meaning the reduction Guchang there gums, nasal bleeding skin and bowel membrane with purpura or bleeding points, or hematemesis and Black manure, women often menorrhagia.
    (8) Neuropsychiatric symptoms such as drowsiness occurs, excitement, and water, zombies and other symptoms, you should consider the possibility of hepatic encephalopathy.

    2. Signs
    (L) faces, looking more sick than before the dark, probably because estrogen increases, so that the body sulfur amino weakened the inhibition of tyrosinase. Thereby increasing the amount of tyrosine into melanin caused by; also may be due to secondary adrenocortical insufficiency, and liver metabolism can not be provided for the secretion of pituitary melanocyte-stimulating hormone induced. In addition to the face (especially around the eyes), the palm texture, and skin wrinkles, etc. are also available on pigmentation. Patients with advanced thin withered face. Cheeks with small blood vessels to dilate, dry lips 10.
    (2), jaundice, jaundice, said there is obvious damage liver cells, the prognosis of some significance.
    (Three) fever, about 1 / 3 of patients with active cirrhosis of the liver often irregular low-heat, it may not be due to the liver caused by heat inactivation of sex hormones, such as testosterone or restore to restore biliary triacontanol urine ketone (etiocholanolone) result. Such fever ineffective treatment with antibiotics, only to disappear when the liver disease improves. In case of constant heat, especially high fever, most tips concurrent respiratory tract, urinary tract or ascites infections, sepsis and other gram-negative bacilli. TB is not uncommon merger.
    (4) abdominal venous engorgement, due to portal vein hypertension and collateral circulation and blood vessels to expand, in abdominal and chest wall can be seen under the engorgement of the subcutaneous veins. Wai, the formation of human umbilical vein protruding head jellyfish-like varicose veins, or veins there signs of continuous intravenous noise, etc. are rare.
    (5), ascites, ascites often prompted the emergence of cirrhosis of the liver is already late in the first, before the advent of regular flatulence. Generally slow accumulation of cases of ascites, while the formation of ascites over the short term there is clearly a predisposing factor and, if infection, upper gastrointestinal bleeding, portal vein thrombosis, and surgical and other incentives, the rapid formation of ascites, and difficult to subside. A large number of ascites and abdominal pressures were significantly higher when the umbilical cord can be formed by highlighting. Because elevated diaphragm, breathing difficulties and heart palpitations can occur.
    (6), pleural effusion, ascites in patients with pleural effusion were not accompanied by rare. See more of which the right pleural effusion, bilateral those who followed, were simply left at least. Pleural fluid produced by the mechanism is not clear, may be related to the following factors: ① Low albumin hyperlipidemia; ② azygos vein, half-azygos vein system pressure increased; ③ liver lymph flow increases resulting in pleural lymphatic vessels to expand, siltation and destruction, lymph spillover and the formation of pleural effusion; ④ increase abdominal pressure, the Ministry of diaphragmatic thinning of tendon cord, and can form a pore, ascites, who can drain the chest.
    (7), splenomegaly, the spleen is usually moderately swollen, and sometimes for splenomegaly. Complicated upper gastrointestinal bleeding, the spleen may be temporarily reduced, or even touching.
    (8) cases of liver cirrhosis, the liver size, with varying degrees of hardness and smoothness, and the amount of liver fat infiltration, as well as liver regeneration, fibrous tissue hyperplasia and the degree of contraction. Early enlargement of the liver surface is smooth, medium hardness, later reduced, hard surface was nodular in general without tenderness, but progressive liver cell necrosis or inflammation around the concurrent hepatitis and liver when there is tenderness and percussion pain.
    (9) the performance of endocrine dysfunction, when gonadotropin secretion in cirrhosis of the liver may reduce the testicular atrophy caused by men, the military one may reduce the secretion of the male breast development and pubic hair sparse, on female patients have been less and amenorrhea, infertility. Estrogen too much, can arise around the telangiectasia spider Germany and liver palms. Spider bite with Germany the improvement of liver function disappeared, and the new Spider filter appears, then prompt liver damage and development. Liver palms are palms redness, particularly in the thenar, small international and fingers at the end of the Department of muscle hypertrophy, showing mottled redness.
    (10) bleeding signs, skin, and the Ministry of membranes (including the oral, nasal, and hemorrhoids) often appear petechia, ecchymosis, hematoma and fresh hemorrhage, is due to impaired liver function, some reduction in coagulation factor synthesis, and (or) hypersplenism due to a decrease of platelet.
    (11) the performance of nutritional deficiencies, such as weight loss, anemia, rough skin. Edema, Taiwan, smooth, angular cheilitis, pale or showed a spoon-shaped nails. Polyneuritis and so on.


Tags: liver cirrhosis

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