Patient: Description of the condition (onset, main symptoms, hospital visited, etc.): More than three years ago, half of the spleen was removed, the last two weeks ago, thought it was biliary pain, the result of hanging water for 4, 5 days after the discovery of the situation is not right, the specific examination, the investigation of ascites symptoms. The following is the examination report. I would like to know if the report concludes that the condition is serious, and I would like to get some follow-up treatment advice on the report. Thank you. Zhang Jian Ao, Department of Infection, Wuhan Union Medical College Hospital
Zhang Jian’ao, Department of Infection, Wuhan Union Medical College Hospital: Your information is quite detailed, and the results suggest: hepatitis cirrhosis decompensated stage. It is caused by chronic hepatitis B. At present, there is no special method for the cure of cirrhosis. The main focus is on symptomatic treatment, inhibiting the process of cirrhosis and treating complications. Your routine blood results are basically normal, indicating that hypersplenism is not yet obvious, abnormal liver function and a small amount of ascites. The main treatment is 1 to protect liver cells, 2 to benefit the bile and 3 to take long-term Chinese medicine to soften the liver and turn the knots, such as compound turtle nail soft liver tablets, Anluo Huafu Wan, liver cool granules, etc. (just choose one), 4 diuretics according to the doctor’s instructions. It is better to consult a liver disease specialist at a hospital.
Patient: Hello, Director Zhang. Thank you for your detailed answer. The doctor who consulted my uncle told him to take adefovir and amifudine, but adefovir is to be taken for a long time and cannot be discontinued, so is it appropriate to keep taking adefovir? At the same time, the doctor told my uncle to have an enhanced CT test, but the doctor said that this test has adverse side effects on people, such as red spots on the body in mild cases, or the possibility of shock or stopping breathing in the middle of the test. Is this test necessary? Is it safe? Thank you.
Wuhan Union Hospital Infectious Diseases Department Zhang Jian Ao: The role of CT is to observe the liver and gallbladder and other organs from the perspective of imaging to see if there are occupying lesions, such as stones, inflammation, hemangiomas, cysts or tumors, etc. Your uncle needs to rule out tumor lesions first because of nodular changes in the liver. Enhanced CT should use a drug to make the image effect clearer, the drug has a few people have allergic reactions. Allergy test can be done first to solve the problem. In case you are afraid of allergic reaction, you can also do MRI, whose image is clearer.
Patient: Director Zhang. Thank you very much for your answer. It was very detailed and easy for us lay family members to understand. Thank you.
Patient: Director Zhang. I’m sorry, I have another question: My uncle’s doctor told him to take adefovir and amifudine (amifudine for six months to a year, and adefovir must be taken all the time without stopping). Is it necessary to take this drug? Is there any other medication that is more suitable to take?
Wuhan Union Hospital Infectious Diseases Department Zhang Jian Ao: The end point of adefovir and lamivudine dosing is difficult to determine, and can only be taken on time and checked regularly under the guidance of a specialist. There are side effects of the second drug, but the incidence is extremely low. In principle, it should be taken for more than one year. It is difficult to say when to stop taking the drug, so follow the doctor’s instructions.
The Department of Infectious Diseases, Wuhan Union Hospital, Zhang Jian Ao: In addition, so far, there are no special drugs to treat hepatitis B. Some drugs and methods have some efficacy. The actual fact is that you will be able to get a good deal on your own, and you’ll be able to get a good deal on your own.