Abstract: Cirrhosis refers to the long-term or repeated damage to the liver due to one or more reasons, which leads to extensive liver parenchyma damage, hepatocyte necrosis, fibrous tissue proliferation, disorder of the normal structure of the liver and hardening of the texture. Can be complicated with splenomegaly, ascites, edema, jaundice, esophageal varices, bleeding, liver coma and so on. Health guide: 1. Active prevention: Liver cirrhosis is the result of gradual degeneration of liver parenchyma caused by different reasons. We should pay attention to the prevention and treatment of various primary diseases, actively prevent and treat chronic hepatitis, schistosomiasis and gastrointestinal infections, avoid contact with and application of substances toxic to the liver, and reduce pathogenic factors. 2. Emotional stability: The liver is closely related to spirit and emotion. Bad mood, depression and anger will all affect the function of the liver and accelerate the development of the disease. Establishing a strong will, cheerful mood, uplifting spirit and eliminating ideological burden will be beneficial to the improvement of the disease. 3. Dynamic and static combination: the compensatory function of liver cirrhosis is decreased, and patients with ascites or infection must stay in bed. During the period of fully compensatory function and stable illness, you can do some relaxing work or appropriate activities and carry out beneficial physical exercise, such as walking, doing exercises, Tai Ji Chuan, Qigong, etc. The amount of activity is that you don't feel tired. 4. Simple medication: blind abuse of general drugs will increase the burden on the liver, which is not conducive to liver recovery. Drugs harmful to the liver, such as isoniazid and barbiturates, should be used with caution or have contraindications. 5. Quit smoking and avoid alcohol: Alcohol can help fire and replenish blood, and long-term drinking, especially hard liquor, can lead to alcoholic cirrhosis. Therefore, drinking alcohol will aggravate the condition of patients with liver cirrhosis and easily cause bleeding. Long-term smoking is not conducive to the stability and recovery of liver disease, can accelerate the process of liver cirrhosis, and has the risk of promoting liver cancer. 6. Diet care: A diet with low fat, high protein, high vitamins and easy digestion is appropriate. Be regular, quantitative and temperate. In the early stage, you can eat more soy products, fruits and fresh vegetables, and eat sugar, eggs, fish and lean meat appropriately; When the liver function drops obviously and there are signs of hepatic coma, the intake of protein should be properly controlled, and a low-salt diet or a salt-free diet should be advocated. The daily intake of salt should not exceed 1 ~ 1.5g, and the drinking water should be within 2000ml. In severe ascites, the intake of salt should be controlled within 500mg, and the intake of water should be within 1000ml. Avoid spicy and irritating items and hard and cold food, and don't eat overheated food to prevent bleeding. Cirrhosis is a chronic progressive liver disease, which is caused by many factors that damage the liver, such as chronic active hepatitis and long-term alcoholism. Mainly manifested as loss of appetite, fatigue, gingival bleeding, liver palm, spider nevus, jaundice, low albumin, splenomegaly, abdominal varicose veins, esophageal and gastric varices, ascites and so on. Serious complications such as gastrointestinal bleeding, hepatic coma and secondary infection often occur in the late stage. Patients with liver cirrhosis are also high-risk targets of primary liver cancer, and regular examination should be paid attention to. Liver cirrhosis can be treated with Chinese and western medicine, which has a certain effect. Prescription 1. Patients with liver cirrhosis should pay attention to rest and avoid strenuous exercise; We should keep an optimistic mood and build up confidence in overcoming the disease. 2. The food used should be digestible and nutritious. High protein, high sugar, high vitamins and low fat are the principles of diet choice for patients with liver cirrhosis. 3. When there is ascites, stay in bed, increase nutrition and limit salt intake. It is best to adopt a salt-free or low-salt diet, with the salt content not exceeding 5g 1 yuan per day. 4. When ascites is obvious, water intake should be limited. Generally, the daily drinking water should be controlled at 1000 ml (equivalent to 2 bottles of salt water bottles used in hospitals). Severe hyponatremia should be limited to 500 ml. 5. Patients with esophageal varices should avoid irritating and hard food, so as not to damage esophageal varices and cause massive bleeding. 6. When hepatic coma is possible, the intake of protein should be limited, and vegetables should be the main food for three meals. 7. Quit smoking and drinking, and don't abuse "liver-protecting" drugs. 8. You should go to the hospital regularly for liver function, alpha-fetoprotein and ultrasound examination. Zhang suffered from chronic hepatitis years ago. Since April last year, he has felt general malaise, obvious fatigue and swelling pain in his right upper abdomen. The doctor diagnosed it as "chronic hepatitis and cirrhosis" after examination. The doctor told him to take an appropriate amount of high-quality animal protein to ensure his nutritional needs. Due to the patients' insufficient understanding of the disease, they did not pay attention to it, and at the same time, they were overworked, which led to abnormal behavior, unclear answers, slow thinking and other early manifestations of liver coma. The patient's family is undecided about this. This doubt is also common sense that people should know, understand and master. Speaking of viral hepatitis B, you must be familiar with it. The patient-who once suffered from hepatitis, did not get a good rest and nutrition, which further damaged liver cells, degenerated cells, necrotized cells and proliferated fibrous tissue. Over time, the liver tissue structure is gradually destroyed and the texture becomes hard. The mild symptoms are loss of appetite, aversion to greasy food, abdominal distension, fatigue and discomfort in the liver area. In severe cases, liver function abnormalities such as ascites, digestion, detoxification, coagulation dysfunction and portal hypertension may occur. It should be pointed out that the early stage of liver cirrhosis should pay attention to rest and properly supplement high-quality protein, which is beneficial to the repair of liver cells. If the damage of liver cells is aggravated, the detoxification function of liver will decrease obviously. At this time, excessive intake of protein will not be worth the loss, resulting in excessive ammonia in the body and increased blood ammonia content, leading to hepatic coma. Therefore, patients with early hepatic coma must strictly control the intake of animal protein. In order to avoid negative nitrogen balance, protein, a leguminous plant with low ammonia production, can be supplemented. Although the blood ammonia decreased after treatment with antihyperglycemic drugs (the normal range was 37-8 1 mmol/L), protein should not be supplemented too quickly or too much. Fresh vegetables and fruits should be supplemented to ensure the supply of carbohydrates and appropriately limit the intake of fat. In addition, patients with liver cirrhosis should strictly abide by the following points: First, strictly ban alcohol, alcohol can aggravate liver cell damage, which is not conducive to liver cell repair. Second, you should avoid rough and hard foods, such as fractures, thorns and hard fruits, to prevent bleeding from esophageal and gastric varices. Third, patients with ascites edema should adopt a low-salt diet with a daily salt intake of less than 2 grams. Four, patients with liver cirrhosis should keep the stool unobstructed, such as constipation, edible sesame oil, honey and so on. To reduce the accumulation of ammonia and prevent hepatic coma. Fifth, eating less and eating more meals is conducive to liver rest and reducing the burden on the liver. It can restore most liver functions, correct hypoproteinemia and improve internal circulation of liver. Renal filtration rate increased and ascites disappeared. However, the recurrence rate of ascites in liver cirrhosis is very high, and the treatment is becoming more and more difficult. Therefore, it is very important to prevent recurrence after discharge. In terms of diet, patients with liver cirrhosis have increased secondary aldosterone, decreased urinary sodium excretion, increased sodium storage in renal distal convoluted tubules, and high-salt diet can further increase blood sodium level, which can induce ascites. At the same time, protein synthesis is impaired and albumin is decreased in patients with liver cirrhosis. If you eat a low-protein diet for a long time, it will aggravate hypoproteinemia and ascites will reappear. However, if you eat a high-protein and high-fat diet in large quantities, it will increase the burden on the liver and worsen the condition. Patients with liver cirrhosis often have esophageal varices, and eating rough food may puncture varicose veins. Upper gastrointestinal bleeding occurred. Therefore, we should vigorously reduce salt, moderate protein and low-fat diet; Eat foods rich in vitamins and choose soft foods that are easy to digest; Avoid overeating, hunger, smoking and drinking, pay attention to food hygiene and prevent diarrhea. Rest to ensure more than 8 hours of sleep every day, avoid fatigue, and gradually increase the amount of activity, from rest to half-day work or even full-time work. Improve the immune function of the body, use Chinese and western medicine to promote the regeneration of liver cells, combine static and dynamic, and participate in physical exercise; Keep a happy mood, avoid sadness, and take part in more recreational activities to enhance physical fitness, improve the body's disease resistance, and promote liver function recovery and hepatocyte regeneration. Prevention of infection Patients with liver cirrhosis have low resistance and are prone to peritoneum and other infections. Moreover, patients with liver cirrhosis already have ascites infection or other infections. After treatment and control, if the control is not thorough, the infection will re-ignite or re-infect, ascites will appear. Therefore, patients with liver cirrhosis should avoid contact with infectious diseases and try not to go to public places during the epidemic of infectious diseases. Once an infection occurs, it should be treated thoroughly as soon as possible. There are more than 200 kinds of drugs that can easily cause liver injury, such as tetracycline, cincofen, antimony, arsenic, chlorpromazine, barbiturates, urethane, azathioprine, isoniazid, p-aminosalicylic acid, chloral hydrate, chloramphenicol, erythromycin, etc., which should be banned or used with caution. Prevention and treatment of complications Patients with ascites due to liver cirrhosis are prone to complications such as upper gastrointestinal bleeding, hepatic encephalopathy, kidney disease, ulcer, hematological diseases, diarrhea and electrolyte disorder. And should be actively treated to minimize the damage to the liver. How to find and treat early liver cirrhosis medical science magazine "Seeking medical advice-It is beneficial to open books" Author: China is a high incidence area of hepatitis B virus infection and hepatitis B, and liver cirrhosis caused by viral hepatitis is the most common, especially post-hepatitis cirrhosis. In foreign countries, especially in Europe and America, alcoholic cirrhosis caused by alcoholism is the most common. The average adult suffers from hepatitis B. Through rest, proper nutrition strengthening and adjuvant treatment with Chinese and western drugs for protecting the liver, 90% of the patients can be cured, and only 65,438+00% of the patients turn into chronic hepatitis. Of the chronic hepatitis 10%, 20% may develop into cirrhosis, and about 1% may develop into liver cancer. So after suffering from hepatitis B, most of them can be cured. Therefore, there is no need to be nervous and panic. The time from viral hepatitis to cirrhosis can be long or short. It takes 20 to 30 years for the long ones and only a few months for the short ones. Therefore, patients should do a good job of self-care, pay attention to conditioning and maintenance, which will not have much impact on life expectancy. Chronic hepatitis must undergo liver fibrosis before it develops into cirrhosis. How to find early cirrhosis? The clinical manifestations of early liver cirrhosis are not obvious, and there may be no symptoms or only mild symptoms, such as fatigue, poor appetite, dyspepsia, nausea, vomiting, right upper abdominal pain, diarrhea and so on. These symptoms are not characteristic, and general gastrointestinal diseases can occur, not unique to early cirrhosis, and it is difficult to find them early simply by symptoms. In the physical examination of early cirrhosis, the liver is often enlarged, and some patients have enlarged spleen, and spider nevus and liver palm can be seen. Liver function tests are mostly in the normal range or slightly abnormal, especially protein changes, such as albumin decrease and globulin increase, and the ratio of albumin to globulin is close to or even inverted. So, what other tests can find early cirrhosis? 1. The ideal gold indicator is to give the patient a liver biopsy. Using 1 s puncture method, a small amount of liver tissue was examined under microscope to find out whether there was fibrosis and connective tissue in the liver. 2. do a b-ultrasound examination. Hepatomegaly can be found in the early stage of liver cirrhosis, and the echo display of liver is enhanced and thickened. Once it develops to the late stage, the inner diameter of portal vein widens to more than 13mm, the width of splenic vein widens to more than 8mm, the spleen thickens, the liver shrinks, and the surface of the liver is not smooth and uneven, often accompanied by ascites. 3. Draw blood to check four serological indexes of fibrosis. Hyaluronic acid (HA), laminin (LN), procollagen Ⅲ (PⅢ P) and collagen Ⅳ (C Ⅳ). Among them, 2 ~ 3 items are obviously increased, so early cirrhosis can be considered. Treatment of early cirrhosis 1. Pay attention to rest properly, don't overwork, and take part in general light work. 2. The diet is mainly high in calories and protein. Eat foods rich in vitamins (fresh vegetables and fruits) and easily digestible foods. Don't eat hard and coarse food. Don't drink. Don't use drugs that damage the liver. 3. Drug therapy Under the guidance of experts, Chinese and western medicines that protect the liver are used to improve liver function. Anti-fibrosis therapies, such as Kangxian Pill, Compound Biejia Ruangan Tablet and γ -interferon have anti-fibrosis effects. If the patient's HBV replication index is positive (such as HBV-DNA positive and HBeAg positive), the nucleoside antiviral drug hepcidin (lamivudine) can be used. But don't take too much medicine, otherwise it will increase the burden on the liver and be unfavorable to the recovery of liver disease. In short, efforts should be made to find and treat early cirrhosis. When the liver disease is still in the stage of fibrosis, through active treatment, the condition can be reversed and it is possible to fully recover. If the disease has progressed to cirrhosis, it can only be relieved by treatment. If the disease has developed to advanced cirrhosis, patients often have some complications, such as hepatic encephalopathy (hepatic coma), upper gastrointestinal bleeding, ascites, hepatorenal syndrome, infection and so on. And the prognosis is poor. What is cirrhosis? Cirrhosis is a chronic progressive diffuse change of the liver caused by various reasons. It is characterized by repeated and long-term damage to liver cells for one or more reasons, leading to degeneration and necrosis of liver cells. After extensive degeneration and necrosis of hepatocytes, connective tissue in the liver regenerated and diffuse proliferation of fibrous tissue appeared. At the same time, hepatocytes in the liver regenerate, forming regenerative nodules, and the normal hepatic lobule structure and blood vessel formation are destroyed, forming false lobules. After a long period of time (years or even decades), the liver gradually deforms and hardens, which is clinically called cirrhosis. Cirrhosis is very common in China, most of which are posthepatitic cirrhosis, and a few are alcoholic cirrhosis and schistosomiasis cirrhosis. Because cirrhosis can be reversed or stopped after active prevention and treatment in the early stage, it will seriously affect the quality of life of patients and even endanger their lives in the later stage, so the prevention and treatment of cirrhosis is very important. What are the causes of liver cirrhosis? The causes of liver cirrhosis can be divided into the following eight categories: (1) Hepatitis virus: the most common are hepatitis B virus, hepatitis C virus and hepatitis D virus infection. Some hepatitis B virus-infected people develop chronic hepatitis, and a small number of chronic hepatitis B develop cirrhosis. About half of acute hepatitis C develops into chronic hepatitis, of which 10% ~ 30% will develop into cirrhosis. Hepatitis D virus depends on hepatitis B virus to produce hepatitis, and some patients develop cirrhosis. (2) Alcohol factor: Long-term heavy drinking leads to liver cell damage, steatosis, necrosis, liver fibrosis, and severe cirrhosis. (3) Cholestasis: Long-term chronic cholestasis leads to hepatocyte inflammation, bile duct reaction and even necrosis, leading to biliary cirrhosis. (4) Congestion factors: Long-term repeated chronic cardiac insufficiency, constrictive pericarditis and hepatic vein occlusion can cause liver congestion, which will lead to necrosis and degeneration of liver cells due to hypoxia, and eventually lead to cirrhosis. Among them, cirrhosis caused by the heart is called cardiogenic cirrhosis. (5) Drug-induced or chemical toxic factors: Long-term use of certain drugs, such as acetaminophen, cincofen and methyldopa, can lead to drug-induced hepatitis and eventually develop into cirrhosis. Long-term exposure to certain chemical poisons, such as carbon tetrachloride, arsenic and phosphorus, can cause toxic hepatitis and develop into cirrhosis. (6) Metabolic disorder: copper metabolic disorder, seen in hepatolenticular degeneration. Iron metabolic disorders are found in hemophilia, galactosemia, fibrocystic diseases, α-antitrypsin deficiency, glycogen storage diseases, tyrosine metabolic disorders and hereditary hemorrhagic telangiectasia. These diseases are related to genetic metabolic defects and can all lead to cirrhosis. (7) Parasitic infection: Schistosoma infection is common in southern China, which can lead to schistosomiasis and further lead to liver fibrosis and cirrhosis. If the human body is infected with Clonorchis sinensis and is not treated in time, cirrhosis will occur. (8) Other factors: high malnutrition can lead to cirrhosis, and the cause of a few cirrhosis is unknown. How to diagnose liver cirrhosis? The typical symptoms of patients with liver cirrhosis are easy to diagnose, but some patients may have no typical clinical symptoms and are in the recessive compensatory period, which is difficult to diagnose at this time. So the diagnosis of liver cirrhosis is a comprehensive diagnosis. (1) History of viral hepatitis, chronic alcoholism, chronic malnutrition, schistosomiasis or chemical drug poisoning. (2) Symptoms: loss of appetite, ascites, nausea, diarrhea, mild hepatosplenomegaly and vascular nevus in the early stage (compensatory stage), ascites, bleeding tendency, jaundice, hepatosplenomegaly and liver volume reduction in the late stage (decompensated stage). (3) Liver function examination: the liver function is normal or slightly abnormal in compensatory period, obviously abnormal in decompensated period, plasma albumin is decreased, globulin is increased, and the ratio is reversed, and γ globulin is obviously increased in protein electrophoresis. (4) Blood test: leukopenia and thrombocytopenia in patients with hypersplenism, and pancytopenia in severe cases. (5) Esophageal barium examination or endoscopic examination, esophageal or gastric varices. (6)B-ultrasound examination: changes in the size, surface and morphology of the liver, echo, thickening of portal vein and splenic vein, ascites, visible fluid dark area, and increased spleen volume. (7) Histological examination of liver: If there is fibrous septa formation, nodular hyperplasia or mixed nodular hyperplasia, diagnosis can be made. Please see here for the full version: /sljk/ybjb/ Xiaohua/gyh.htm.