Cirrhosis of the clinical manifestations

The performance of early cirrhosis »
1, pathological findings: liver normal size, quality Shaoying. Hyperplasia is the main characteristics of active fiber, the fiber bundle formed large and small, single-renewable nodules uneven, only a small number of false lobular form.
2, the functional performance: moderate liver dysfunction, such as: ALT, AST increased slightly, without jaundice, reduce serum protein mild to moderate, pro-blood of normal time, normal blood ammonia.
3, clinical symptoms: no symptoms, but also looking for performance.

Cirrhosis of the onset and course of the general than the slow, insidious three to five years or more than a decade ago, its clinical manifestations of liver function can be divided into compensatory and decompensated period, but two boundaries is not obvious or There are overlaps.
First, symptoms of decompensated liver function lighter, and often the lack of specificity, to fatigue fatigue, anorexia and indigestion oriented. May have nausea, disgust oil, abdominal Flatulence, abdominal discomfort, pain and diarrhea.
Second, liver function decompensated symptoms significantly.
(A) of liver dysfunction of the clinical manifestations:
1. Systemic symptoms and general nutritional status of poor, suffering from weight loss weakness, Jingshenbuzhen, severe, debilitating and bedridden. Rough skin dry, looking gloomy dark. Often anemia, Sheyan, Koujiao Yan, Ye Mang, such as swelling and multiple neuritis.
2. Gastrointestinal symptoms.
3. Hemorrhage and anemia.
4. Endocrine disorders.
(B) the levy portal hypertension clinical manifestations constitutes portal hypertension clinical manifestations of the three levy a splenomegaly, and the establishment of collateral circulation in the open, ascites, have important clinical significance. In particular, the establishment of collateral circulation and open the diagnosis characteristic value.
Cirrhosis of the clinical manifestations
Hepatitis patients with cirrhosis of a general systemic symptoms, there are many features of the performance of liver disease, different patients can be very different. Apart from a general clinical manifestations of chronic hepatitis, its main clinical features are abnormal liver function and portal hypertension. However, there are some occult patients with cirrhosis without any clinical manifestations, even in the laparotomy, or other examination of the autopsy found.
(A) General symptoms
Typical of the general situation and nutrition are poor, emaciated, Jingshenbuzhen, poor appetite, inability to self-induced fatigue, abdominal distention and most of the afternoon and evening of the case, may have left and right quarter of help discomfort or pain, the sense of falling, Some patients have irregular fever, consciously I & Poor's to Chen Qi for the heavy, high fat foods into easily lead to diarrhea.
(B) symptoms and signs
1. Skin changes in some patients with pigmented looking filthy, with a yellow. IVC in the drainage area that Spider Germany. Hands can be a liver palms, telangiectasia also more common, mainly in the dry skin of patients with cirrhosis of the face and the double-thigh skin. Some patients with abdominal vein exposed, can be re-shaped with varicose.
2. Cirrhosis of the liver and spleen in the early days, the liver can be enlarged, the late smaller, more hard and texture, and at the surface can be large or small uniform distribution of nodules. Liver size, hardness, the surface is smooth, and fatty infiltration of the liver and the number of liver regeneration, fibrous tissue proliferation and the extent of the contraction. Most patients with varying degrees of licensing great. Decompensated liver function are generally no obvious sign of ascites.
3. Liver dysfunction of the clinical manifestations
(1) Huang yields: patients with cirrhosis of the liver cells are more jaundice, should be considered once: ① that have active hepatitis diseases. ② intrahepatic cholestasis: cirrhosis when bile secretion and generate all aspects of the process may occur obstacles caused cholestasis. There are three main reasons: sodium-potassium ATP dysfunction; transit by inhibiting cell, liver cell membrane permeability changes. ③ serious liver failure: that disease often has to end-stage development, accompanied hepatic encephalopathy, very poor prognosis. ④ cirrhosis on the basis of malignant transformation has occurred: the rapid deepening jaundice should suspect a liver tumor caused by the door of the transfer of bile duct obstruction.
(2) hemorrhage and anemia: a serious decline affect liver function prothrombin and other coagulation factor Synthesis at the same time because of hypersplenism and giant bone marrow cells generate invalid. Lead to thrombocytopenia; platelet membrane phospholipids, sugar abnormal protein structure and function of the lower adhesion and aggregation, the disease often appear purple, nose bleeding, gingival and gastrointestinal bleeding. Patients have varying degrees of anemia, and more from lack of nutrition, lower intestinal absorption, hypersplenism and gastrointestinal bleeding, and other factors.
(3) gastrointestinal symptoms: appetite decreased significantly, the sense of abdominal discomfort after eating and guns bulging, heavy flu can be nausea, vomiting and even the fat and protein tolerance of difference. And because of ascites in patients with stomach flu Gas and abdominal distention, there may be late in the dark intestinal toxicity. With the above symptoms of a gastrointestinal congestion, swelling, inflammation caused by digestion and absorption dysfunction and bowel-related disorders group. Chronic cholecystitis also quite common, and its symptoms difficult to distinguish between symptoms of cirrhosis.
(4) and endocrine problems: ① hypoglycemia in patients with liver cirrhosis or high blood sugar can be. Serious hypoglycemia in patients with less, the reasons are: On the one hand, the reserve capacity of the liver very strong, as long as 20 percent of the liver can maintain normal blood sugar stable kidney on the other hand there are differences of Health's ability glycogen, when the liver function Subside, it may have to replace a considerable portion of glucose. Therefore, serious low blood sugar only to serious liver damage in patients with advanced cirrhosis. High blood sugar and abnormal glucose tolerance is found in some patients with cirrhosis. ② sexual dysfunction. As a male hypothalamic pituitary a gonad dysfunction, the performance of sexual dysfunction and feminization. Such as impotence, men breast development, the serum of patients with single-and lower-free Army, the military and one abnormal ratio of estrogen. Female patients will have the leisure, without ovulation and menstrual cycle to reduce the incidence increased. Infertility common levy and decreased sexual desire. ③ renin-angiotensin an unusual one aldosterone system.
(5) of water, electrolyte disturbance
(6) gallbladder disease: there are more patients with cirrhosis of gallbladder disease, gallbladder wall thickening Changbiaoxianwei, cholestasis, gallbladder, and other volume changes.
(7) bone and joint changes: some patients with cirrhosis-may appear to refer to (toe), mast occasionally bone and joint disease.
4. Portal hypertension clinical manifestations of the levy
(1) varices ① about 40% - 70% of patients with cirrhosis have esophageal varices. As patients with cirrhosis often reflux esophagitis can erode the bottom of esophageal mucosa, or hard food caused by mechanical factors such as trauma caused bleeding varicose veins. Because of a cough, nausea, vomiting and other reasons that have increased the portal pressure suddenly increased, more than the meagre varicose vein wall and the affordability of bleeding. ② abdominal wall and Qizhou varicose veins. ③ Zhihe form. Waizhi can form hemorrhoids or mixed hemorrhoids, can be broken when the bleeding.
(2) congestive splenomegaly and spleen Gong hyperthyroidism: enlargement of the spleen, often reduce blood cells, known as hypersplenism.
(3) ascites: the formation of ascites in patients with cirrhosis many factors common to the result. Some patients can still pleural effusion in the left chest多见.
(4) of the door cycle encephalopathy: the extent to the minor EEG changes, personality changes, the orientation of the obstacles to a different degree of coma.