What are the symptoms of cirrhosis?
What are the symptoms of cirrhosis ah? I have a grandfather of ascites due to cirrhosis, liver recent discomfort will not be cirrhosis ah?
Answer:
The performance of early liver cirrhosis?
1, the performance of pathology: the size of a normal liver, Shao Ying quality. The main active Fibroelastosis characterized by the form of small fibers, single-renewable uneven nodules, only a small number of false lobular form.
2, functions manifestations: moderate liver dysfunction, such as: ALT, AST increased slightly, without jaundice, serum protein to reduce mild to moderate, pro-ling blood of normal time, normal blood ammonia.
3, the performance of clinical symptoms: no symptoms, may also be looking for performance.
Cirrhosis of the onset and course of development than those slow in general, can be hidden or 3-5 years, more than a decade, the clinical manifestations of liver function can be divided into compensatory and decompensated period, the two phases of the boundaries are not obvious or There is overlap.
First, symptoms of decompensated liver function less often lack the specificity to fatigue fatigue, loss of appetite and indigestion-based. There can be nausea, tired of oil, abdominal flatulence, abdominal discomfort, abdominal pain and diarrhea.
Second, liver decompensation period symptoms significantly.
(A) liver reduce the clinical manifestations:
1. Systemic symptoms with the general nutritional status of poor, weak thin, Jingshenbuzhen, those with severe and debilitating bedridden. Rough dry skin, dark gloomy face. Anemia often, glossitis, angular cheilitis, night blindness, such as edema and multiple neuritis.
2. Gastrointestinal symptoms.
3. Anemia and bleeding tendency.
4. Endocrine disorders.
(B) portal hypertension symptoms of clinical manifestations constitutes a sign of portal hypertension in three clinical-splenomegaly, the establishment of collateral circulation and open, ascites, have important clinical significance. In particular, the establishment of collateral circulation and open to the diagnosis with characteristic value.
Cirrhosis of the clinical
Patients with cirrhosis of the general body symptoms, there are many characteristics of the performance of liver disease, different patients may be very different. In addition to general clinical manifestations of chronic hepatitis, its main clinical features of liver dysfunction and portal hypertension. But there are also some of the occult in patients with liver cirrhosis without any clinical manifestation, even laparotomy on the other, or check the autopsy found.
(A) general symptoms
Typical patients and the general situation of both poor nutrition, weight loss, Jingshenbuzhen, poor appetite, fatigue felt powerless, abdominal distension and more especially in the afternoon and evening may have left and right quarter of the district to help dull pain or discomfort, a sense of falling, Some patients have irregular fever, I consciously & P, for the early morning to heavy, high-fat food into the cause diarrhea and so on.
(B) of the symptoms and signs
1. Some of the changes in the skin of patients with dirty face pigmentation, can be stained yellow. In the superior vena cava drainage area can be seen spiders and Germany. Both hands to hold the liver was, also telangiectasis more common, mainly in the dry skin of patients with cirrhosis of the two-thigh Agency and facial skin. Part of the patient’s abdominal wall exposed vein, the show will be re-like varicose.
2. Cirrhosis of the liver and spleen situation early, liver enlargement may be, less advanced, and more hard texture, surface and the price can be large or small nodule uniformly distributed. Liver size, hardness, the surface is smooth, and fatty infiltration of the liver and the number of liver regeneration, fibrosis and the degree of contraction. The majority of patients with varying degrees of large licensing. Decompensated liver function are generally levy no ascites.
3. Liver dysfunction of the clinical
(1) Huang yield: jaundice in patients with liver cirrhosis of the liver cells are mostly, the event should be considered: ① said there is active hepatitis diseases. ② intrahepatic cholestasis: when the liver bile secretion and generate the course of all links can occur and cause obstacles to cholestasis. There are three main reasons: sodium-potassium ATP dysfunction; cells by inhibiting transfer; liver cell membrane permeability changes. ③ severe liver failure: diseases that often have to develop end-stage, often accompanied by hepatic encephalopathy, very poor prognosis. ④ cirrhosis on the basis of malignant transformation has taken place: the rapid deepening jaundice should have suspected hilar tumor metastasis caused by bile duct obstruction.
(2), anemia and bleeding tendency: a serious decline affect liver function and prothrombin other clotting factor synthesis; at the same time because of hypersplenism and bone marrow megakaryocytes generated null and void. Lead to thrombocytopenia; platelet membrane phospholipids, sugar structure of the abnormal protein aggregation and adhesion and the low, the disease often purple, nose bleeding and gum bleeding, such as the gastrointestinal tract. Patients have varying degrees of anemia, nutrition and more by the lack of intestinal absorption is low, hypersplenism and gastrointestinal bleeding caused by other factors.
(3) gastrointestinal symptoms: loss of appetite decreased significantly, a sense of abdominal discomfort after eating gun and inflation, may re-flu nausea, vomiting and even, fat and protein for poor tolerance. And as a result of ascites in patients with gastrointestinal gas and a sense of abdominal distension, can occur late in the dark intestinal toxicity. The above-mentioned symptoms and have a gastrointestinal stasis, edema, inflammation caused by the digestion and absorption of intestinal dysfunction as well as the rich group of related disorders. Chronic cholecystitis is quite common, and its symptoms difficult to distinguish between symptoms of cirrhosis.
(4), endocrine disorders: ① to hypoglycemia in patients with liver cirrhosis or high blood sugar. Severe hypoglycemia in patients with the less reason is: on the one hand, strong reserves of the liver, as long as 20% of the normal liver can maintain a stable blood sugar; kidney on the other hand, have the ability to gluconeogenesis, liver function It can be a substitute for less serious generate a considerable portion of glucose. As a result, severe low blood sugar only to serious liver damage in patients with advanced liver cirrhosis. Hyperglycemia and impaired glucose tolerance can be found in some patients with liver cirrhosis. ② sexual dysfunction. As the male hypothalamus-pituitary-gland dysfunction, manifested as decreased sexual function and feminization. Such as impotence, breast development men, one in patients with serum total and free-to lower-military and military-and abnormal ratio of estrogen. Female patients can have as free, and without reducing the menstrual cycle, ovulation rate increased. Infertility common symptoms and loss of libido. ③ renin-angiotensin-aldosterone system abnormalities.
(5) of water, electrolyte disturbance
(6), gallbladder disease: Patients with cirrhosis are more gallbladder disease, usually gallbladder wall thickening, cholestasis, gallbladder volume changes and so on.
(7) changes in bone and joint: cirrhosis patients may occur as part of the fingers (toe), and occasionally hypertrophic osteoarthropathy.
4. Portal hypertension clinical performance
(1) ① varicose veins about 40% - 70% of patients with cirrhosis have esophageal varices. Often in patients with cirrhosis due to reflux esophagitis erosion can be lower esophageal mucosa, or hard food due to mechanical injury caused by factors such as variceal bleeding. As a result of coughing, nausea, vomiting and so on so that the portal has increased the pressure suddenly increased over the low wall of the varicose vein and the bearing capacity of bleeding. ② abdominal wall to Qi Zhou and varicose veins. ③ the formation of hemorrhoids. The formation of internal or external hemorrhoids can be mixed hemorrhoids, bleeding can be broken down.
(2) congestive splenomegaly and splenic reactive hyperthyroidism: enlargement of the spleen at the same time, often to reduce the peripheral blood cells, known as hypersplenism.
(3) ascites: the formation of ascites in patients with cirrhosis to make a number of factors. Some can occur in patients with pleural effusion, often on the left side of the chest.
(4) the door systemic encephalopathy: a degree from the minor EEG changes in personality change, orientation to the obstacles to varying degrees in a coma.
