Human energy is very limited, I would like to write more articles on science, but I have too much work to do, I can’t do it! However, recently I happened to look at my article “How to detect cirrhosis early?” However, recently I happened to look at my article “How to detect cirrhosis early? I finally tried to squeeze in some time to talk about some thoughts on the treatment of cirrhosis of the liver in hepatitis B, thinking back to the examples of patients who are often deceived by advertisements. Generally speaking, cirrhosis can be divided into two stages: the compensated stage and the decompensated stage. In the compensated phase of cirrhosis, although the liver has been partially sclerotic, but the proportion of sclerosis is not high, because the liver can use the original preservation of the “reserve power”, sclerosis of the liver is still “as if nothing happened”, therefore, at this time, cirrhosis is often hidden. I have already posted the methods for early detection of cirrhosis, so I will not repeat them here. So, what should we do about compensated cirrhosis? First of all, we need to assess whether the current cirrhosis will continue to develop, depending on whether there is still hepatitis activity, often manifested as elevated transaminases, sometimes accompanied by elevated bilirubin, in addition, we need to check the HBV DNA status of the hepatitis B virus, if the HBV DNA is above 10,000 copies/mL, long-term antiviral treatment is necessary, through long-term antiviral treatment can achieve the control of the virus, delay the development of The course of antiviral treatment is very long, usually more than 5 years, because it takes a long time for the remission and reversal of liver cirrhosis. If the HBV DNA is less than 10,000 copies/mL, but the aminotransferase is significantly elevated, antiviral treatment is also required. This is because the reagents used to detect HBV DNA in China are somewhat less sensitive, and some domestic reagents to detect HBV DNA negative people still have HBV DNA higher than 10,000 copies/mL, and also elevated transaminases usually indicate the persistence of the immune system’s process of clearing hepatitis B virus from the liver. Of course, if HBV DNA is found to be below 10,000 copies/mL and transaminases are also normal (without the use of enzyme-lowering drugs), despite cirrhosis, we can probably hold off on antiviral therapy and learn about the situation by regularly monitoring HBV DNA and transaminases, and start antiviral therapy as soon as the above treatment conditions are found to be met. The really tricky part is dealing with decompensated cirrhosis. The so-called decompensated cirrhosis means that a higher percentage of the liver is cirrhotic and the liver’s “reserve power” is depleted, so the liver cannot perform the tasks it should, just like a factory with insufficient production capacity. Liver ascites, “foot swelling”, body yellow, eye yellow and other jaundice manifestations, these conditions of cirrhotic patients, treatment is more complex: not only to supplement albumin, plasma, but also to protect the liver, anti-yellowing treatment, more diuretic to eliminate “foot swelling”, ascites, and most importantly, to The most important thing is to take antiviral drugs for life and to prevent drug resistance; all these aspects of treatment must be taken into account, so the condition often requires hospitalization at this time. In a few cases, liver failure is the cause of death. However, most patients can survive this difficult period. In the diagnosis and treatment of cirrhosis, there is a more important issue that needs attention, and that is the esophageal varices caused by cirrhosis, which is the most important reason for cirrhotic patients to “spit blood”. In “The Romance of the Three Kingdoms”, Zhou Yu vomited blood because he “lost his wife and lost his army”, which is said to be the result of alcoholic cirrhosis caused by long-term “booze”, and esophageal varices cause blood vessels to rupture when angry. The sudden rise in pressure causes the blood vessels to rupture and blood flows continuously into the stomach, resulting in vomiting blood, which is life-threatening in serious cases; since esophageal varices are so serious, how can they be prevented? First of all, cirrhotic patients should do gastroscopy immediately if they find enlarged spleen by ultrasound, and if gastroscopy finds severe or moderate esophageal varices, they should take oral “Takeaway” to reduce heart rate and vascular pressure, and the dose of the drug should reduce heart rate by 25% without side effects as the principle, and life needs to be slow-paced. To avoid anger, eat slowly and chew, do not eat coarse and hard food, stool can not force, to keep the bowel movement; for patients with mild varicose veins, according to the presence of ascites, jaundice, low albumin and other conditions to decide. Another issue that should be taken seriously in cirrhosis is the early detection of liver cancer in a timely manner. Although the incidence of liver cancer is very low, only a few percent, because cirrhotic patients are a high-risk group for the occurrence of liver cancer, and the treatment effect of liver cancer has a great relationship with the early and late detection of liver cancer. Therefore, cirrhotic patients should still have regular checkups in order to detect possible early liver cancer in time. Generally, it is required to check ultrasound every six months and to test fetoprotein if necessary; if the cirrhosis is severe, the interval of ultrasound examination should be shortened to 3 months, and once the ultrasound finds suspicious lesions, further CT-enhanced scans of the upper abdomen should be performed to clarify the condition. The treatment plan for cirrhosis needs to be different from person to person and needs to be seen under the guidance of a professional doctor, but the patients themselves should also have an understanding of the disease so that they can better implement the doctor’s treatment plan.