第四篇第十四章肝硬化（The fourth and fourteenth chapter Cirrhosis）.docVIP

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第四篇第十四章肝硬化（The fourth and fourteenth chapter Cirrhosis）.doc

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第四篇第十四章肝硬化（The fourth and fourteenth chapter Cirrhosis）

第四篇第十四章肝硬化（The fourth and fourteenth chapter Cirrhosis） Definition * is a common, chronic, progressive liver disease characterized by various causes of diffuse fibrosis, leaflets, and regenerative nodules Multiple system involvement is the major manifestation of hepatic dysfunction and portal hypertension * late gastrointestinal hemorrhage, hepatic encephalopathy, secondary infection and other serious complications are frequent * the liver is only fibrous hyperplasia or only nodular hyperplasia of liver cells can not be called cirrhosis. Such as congenital fibrosis of liver and focal nodular liver cell proliferation Etiology and pathogenesis * viral hepatitis * alcoholism: 80g/d, 10 years Schistosomiasis japonica Cholestasis * circulatory disorders * industrial poisons and drugs Malnutrition Metabolic disturbance Hemochromatosis Hepatolenticular degeneration Alpha-1 is lacking in trypsin resistance * immune disturbance Autoimmune hepatitis * unknown cause Nonalcoholic steatohepatitis Various reasons Diffuse degeneration and necrosis of liver cells, fibrous collapse of hepatic lobules, fibrous hyperplasia, nodular regeneration of hepatocytes Repeated repair of injury and repair Structural alterations of hepatic lobules, alterations of hepatic blood circulation pathway, hepatic deformation and hardening Portal hypertension, hepatic insufficiency Pathology * nodular cirrhosis Diameter greater than 3~5 mm, no more than 1 cm, the most common * nodular cirrhosis of the liver The diameter is 10~30 mm and the maximum is 50 mm * size, nodule, mixed cirrhosis Combination of size nodules * schistosomiasis liver fibrosis Pathological changes of liver cirrhosis * cirrhosis * portal hypertension and lateral collateral circulation are open * splenomegaly * portal hypertensive gastropathy and enteropathy * liver lung syndrome * atrophy of testis or ovary, thyroid gland and adrenal gland Clinical manifestation * the clinical manifestations are diverse, the onset is often hidden, a