OVERVIEW
Overview of Hepatocellular Jaundice
Hepatocellular jaundice is caused by extensive damage to hepatocytes due to various etiologic factors, resulting in impaired uptake and binding of unconjugated bilirubin by hepatocytes, so that the concentration of unconjugated bilirubin in the serum is increased, while some undamaged hepatocytes can continue to uptake and combine unconjugated bilirubin to conjugated bilirubin, but a part of conjugated bilirubin can not be excreted in capillary bile ducts, and is instead returned to hepatic lymphatic fluid and blood by the interstitial space of necrotic hepatocytes. However, some of the bound bilirubin is not excreted in the capillary bile ducts, but flows back into the hepatic lymphatic fluid and blood through the necrotic hepatocyte interstitial space, or the excretion of bound bilirubin is blocked due to the degeneration of hepatocytes, swelling, inflammatory lesions in the confluent area, and the accumulation of bile in the capillary bile ducts and small bile ducts and the formation of bile plugs, which results in the overflowing of bound bilirubin through the small bile ducts and the flow of bound bilirubin into the hepatic lymphatic flow and blood, and ultimately results in the increase of bound bilirubin in the serum and the development of jaundice.
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Department
Gastroenterology, Hepatology
Clinical symptoms
Fever, malaise, poor appetite, pain in the liver area, liver palms, spider nevi, enlarged spleen, ascites, yellowing of the skin and sclera.
Harmful effects
It not only destroys the function of the liver, but also affects the kidney, heart, lungs and blood clotting function.
Examination
Serum total bilirubin, unconjugated bilirubin, conjugated bilirubin, urinary bilirubin, urobilinogen, fecal bilirubin, liver function tests, histologic examination of the liver, etc.
Diagnosis
Diagnosis is based on fever, malaise, poor appetite, liver palms, spider nevus, enlarged spleen, yellow staining of the skin and sclera, combined with histologic examination of the liver.
Treatment principle
Eliminate the cause of the disease and give symptomatic and supportive treatment.
Curability
Symptoms can be improved with active treatment.
Dietary advice
Give high-calorie, high-protein, high-sugar, low-fat, low-cholesterol, vitamin-rich, easy-to-digest foods. Abstain from alcohol and avoid rough and hard foods.
Etiology
Causes
This disease is caused by extensive damage to liver cells due to immature liver development, hypoxia, infection, inborn metabolic diseases, hypothyroidism, viral hepatitis, cirrhosis and liver cancer.
Symptoms and Diagnosis
Typical symptoms
1. Liver disease itself, such as acute hepatitis, may have fever, fatigue, poor appetite, pain in liver area, etc.; chronic liver disease, may have liver palpitation.
In chronic liver disease, there may be liver palms, spider nevus, enlarged spleen or ascites.
2. The skin and sclera are light yellow to golden yellow, and the skin is sometimes itchy.
Diagnostic basis
1. Clinical manifestations
(1) manifestations of liver disease itself: for example, in acute hepatitis, there may be fever, fatigue, poor appetite, pain in the liver area and so on; in chronic liver disease, there may be liver palms, spider nevus, enlarged spleen or ascites and so on.
(2) Skin and sclera: light yellow to golden yellow, skin sometimes itchy.
2.Laboratory examination
(1) Serum bilirubin: total serum bilirubin is elevated, unconjugated bilirubin and conjugated bilirubin are elevated, among which conjugated bilirubin is more obvious.
(2) Urinary bilirubin: urine bilirubin is positive, urobilinogen is often increased, fecal bilirubin may be normal, decreased or absent.
(3) Liver function tests: according to different liver diseases, the following tests may be abnormal: elevated aminotransferase, elevated prothrombin time, elevated bilirubin, and elevated bilirubin.
Prolonged prothrombin time. In severe liver disease, cholesterol, cholesteryl ester, cholinesterase activity can also be decreased. Alkaline phosphatase and gamma-glutamyl transpeptidase are elevated in the presence of intrahepatic cholestasis. Serum albumin decreases. (4) Histologic examination of the liver: It is valuable for the diagnosis of diffuse liver disease.
Treatment
Treatment policy
Eliminate the cause of the disease, actively treat the primary disease, give hepatoprotective and symptomatic and supportive treatment.
Drug treatment
1. Hepatoprotective drugs
Such as reduced glutathione, glycyrrhizic acid glycoside preparation, potassium magnesium mentholatum, etc.
2. Traditional Chinese medicine
Such as Yin gardenia yellow injection, bitter ginseng injection or bitter yellow injection have anti-inflammatory, bile-relieving and yellow-lowering effects, and can be used as appropriate.
Prognosis
Prognosis can be improved by active treatment.
Questions you may be concerned about
How to treat hepatocellular jaundice
Hepatocellular jaundice can be caused by viral hepatitis, drug-induced hepatitis and other causes. Hepatocellular jaundice can be treated with medicines to protect liver and reduce jaundice.
1. Viral hepatitis: Hepatocellular jaundice caused by viral hepatitis can be treated with antiviral drugs, such as entecavir, lamivudine, etc. At the same time, liver-protecting drugs such as glutathione and diammonium glycyrrhizinate capsules can be given to prevent liver jaundice, while anti-inflammatory cholestyramine tablets and ursodeoxycholic acid capsules can help jaundice to subside.
2. Drug induced hepatitis: Hepatocellular jaundice caused by drug induced hepatitis should be stopped immediately and treated with hepatoprotective drugs such as glutathione.
Hepatocellular jaundice, it is recommended to go to the regular hospital in time, under the guidance of physicians standardized diagnosis and treatment, to avoid delaying the condition.
Nursing care
Daily care
1. Avoid scratching if itching to avoid infection.
2. Keep skin clean and mouth clean.
3. Reduce activities appropriately and participate in light work.
4. Follow the doctor’s instructions for medication and regular review.
Diet
Give high-calorie, high-protein, high-sugar, low-fat, low-cholesterol, vitamin-rich, easy-to-digest food. Prohibit alcohol and avoid rough and hard food.