Location of the liver
The liver is located just below the right side of the body bones and is covered by the right rib cage. The liver is connected to the diaphragm by a fascial tissue called the sickle ligament. When the body is lying on its back or inhaling heavily, the liver is pressed towards the body of the rib cage due to the movement of the diaphragm and part of the liver can be palpated from below the rib cage. When one suspects liver disease, doctors usually palpate the liver by touching it from under the ribs to get a preliminary idea of the changes in liver texture and shape. In normal people, the liver is rubbery and soft, but when you have hepatitis, cirrhosis or liver cancer, the liver is enlarged, deformed and hard.
What is the structure of the liver?
The liver is the largest substantial organ in the body, weighing 1/40-1/50 of body weight. The average adult man’s liver weighs 1.2-1.5 kg, while an adult woman’s weighs about 1 kg. These liver cells contain more than 2,000 kinds of biological enzymes, which are the medium of chemical reactions in the human body and participate in all kinds of life activities in the body. chemical action.
Hepatocytes do not exist alone, but are made up of a certain number of hepatocytes assembled into liver lobules, and the liver can be said to be an internal organ made up of numerous liver lobules. The human liver is divided by the sickle ligament into two lobes, the right lobe is large and thick, accounting for about two-thirds of the total liver, and this left and right lobe structure is also found in fish and turtles.
In addition to the above structures, the liver also includes other important components such as blood vessels, including arteries that carry oxygenated blood and veins that carry carbon dioxide blood back to the heart; in addition to these two groups of vessels, the liver has portal vessels that carry nutrients absorbed by the gastrointestinal tract to the liver and support the liver’s activities. The blood flowing to the liver from both arterial and portal vessels of the liver amounts to about 15% milliliters per minute, while the same amount of blood flows back to the heart through the veins.
What are the metabolic functions of the liver?
The metabolic function of the liver is to convert the nutrients taken from food into substances that the body can use. The metabolic role of the liver is diverse and can be divided into.
1. protein metabolism.
2. sugar metabolism.
3. lipid metabolism.
4. vitamin metabolism.
5. mineral and trace element metabolism.
6, bile acid metabolism.
7, hormone metabolism, etc.
(1) Protein metabolism in the liver
Protein metabolism refers to the synthesis by the liver of the human digestive tract into amino acids, which are transported into the liver through the portal vein, and then the liver synthesizes these amino acids into clear (albumin), fibrin and other components, and these recombined protein components are transported to various parts of the body through the blood, and then become useful materials for building the body. Protein metabolism is the most important function of the liver. When cirrhosis occurs, the protein synthesis function of the liver is low, and it cannot synthesize protein adequately, which can cause symptoms such as swelling of the extremities and ascites.
(2) Glucose metabolism and lipid metabolism
Gluconeol and lipid metabolism are also important components of liver metabolism. The metabolic function of these two substances is simply to produce and provide energy for human activities, and to convert excess nutrients into liver glycogen for storage in the body as a backup. The process is that sugars consumed through food (including sugars contained in rice and other pasta) are digested and absorbed through the intestine and transported to the liver, which converts them into energy needed by the body and liver glycogen for storage through a series of chemical reactions. Depending on the body’s needs, liver glycogen is broken down in the liver into glucose, which provides energy for the liver’s own activities, or enters the bloodstream to become energy for human activities. In addition, excessive intake of sugar and fat becomes neutral fat and accumulates in the liver, which is then broken down into fatty acids for use by the body when it needs them, which is how the liver metabolizes sugar and fat.
(3) Other metabolic functions of the liver
In addition to the protein metabolism and sugar and fat metabolism mentioned above, the liver also has a variety of other metabolic functions, such as vitamin metabolism, metabolism of iron, copper, zinc and other elements and trace elements, inactivation of pituitary gland and sex hormones, etc.
What is the “detoxifying effect” of the liver?
Detoxification is one of the important functions of the liver, along with metabolic functions. The detoxification of the liver means that the toxic substances produced in the body and those taken in from outside the body are transformed into water-soluble compounds through a series of chemical reactions in the liver, such as oxidation, reduction, hydrolysis and synthesis, and excreted from the body through urine and bile. Ammonia is the most representative toxic substance produced in the human body. When proteins in food enter the intestine and are decomposed, ammonia and other harmful substances can be produced, as well as ammonia produced by the decomposition of tissue proteins, which are all waste products of decomposition. This is the cause of hepatic encephalopathy, which is common in the late stages of cirrhosis. The liver protects the body by converting such harmful ammonia into substances such as urine disorders through a series of chemical processes and excreting them out of the body through urine. In addition, the most representative foreign toxic substances is ethanol (i.e. alcohol), drinking alcohol into the body through the oxidation reaction into acetaldehyde, and acetaldehyde is the root cause of discomfort, headache, vomiting after drinking. Acetaldehyde is chemically decomposed into acetic acid by the enzyme acetaldehyde dehydrogenase, so that the alcohol ingested into the body eventually enters the blood in the form of acetic acid, or is further decomposed into water and carbon dioxide into the blood. After such a series of liver detoxification reactions, alcohol is converted into substances that are as harmless as possible to the body. In addition to detoxifying substances such as ammonia and alcohol, the liver also detoxifies food additives and drugs. In addition, the astrocytes in the liver “phagocytose” toxins in the blood, tumor cells in the pigment j and necrotic red blood cells, etc., which means digestion and detoxification.
Why is the liver called the “human synthesis chemical factory?
The liver is responsible for various functions and roles that are indispensable for human life activities, and its complex functions are broadly divided into the following four areas: @Protein metabolism (described earlier); @Metabolism of fat and sugar, providing energy for human activities and resynthesizing excess glucose into hepatic glycogen, which is stored in the body for backup; @Transformation of toxic substances produced by metabolism in the body or ingested from outside the body into water-soluble substances through the liver. This is the detoxification function of the liver; @Bile is synthesized, and bile is concentrated in the gallbladder and discharged into the intestine. All these roles and functions are accomplished through the decomposition, synthesis, oxidation, reduction and other chemical degrees of the liver. Therefore, the liver is worthy of the title of “comprehensive chemical factory of human body”.
How is bile secreted and excreted?
When it comes to bile, people often think that it is produced by the gallbladder, but in fact, it is the liver that produces bile. When fatty food enters the duodenum, the gallbladder discharges bile in the right amount to help digestion and absorption. If the bile ducts become blocked due to diseases such as bile duct stones and bile duct cancer, the bile cannot enter the intestines and the accumulated bile enters the bloodstream, causing a dramatic increase in the amount of moglobin in the blood, resulting in a yellowish staining of the conjunctiva and skin, which is often referred to as “jaundice”. The appearance of jaundice often indicates the occurrence of acute or chronic liver disease or bile duct obstruction.
What are the main aspects of the liver’s ability to compensate and regenerate?
As we described earlier, the liver plays an extremely important role in the production of constituent substances such as albumin and provides energy for vital activities, so a loss of vitality of the liver can have unimaginable consequences. In order to ensure that the liver can continue to work effectively, the liver has the ability to perform activities and processes that greatly exceed the needs of the human body in daily life, and it has a strong compensatory and regenerative capacity. The strong compensatory and regenerative capacity of the liver is mainly manifested in the following aspects.
(1) The complementary function of liver cells.
As mentioned in the previous article, the so-called liver disease is the disease caused by the decline of liver function due to the destruction of liver cells. The human liver is composed of more than 300 billion hepatocytes, some of which are destroyed without significant symptoms such as gangrene. This is due to the fact that while some hepatocytes are destroyed, the remaining normal cells can maintain the normal activities and functions of the liver through compensatory proliferation, replacement and compensation, which is also known as the complementary function of hepatocytes. This has a double significance for the human body, on the one hand, it ensures the normal function of the body as much as possible, on the other hand, it makes the liver partly damaged often without conscious symptoms, which also delays the patient’s timely medical treatment.
(2) The liver is the “silent organ” without nerves.
As a matter of fact, there are no peripheral nerves in the liver, so even if a lesion occurs in the liver, it is usually painless, unlike the stomach, intestines, heart and other organs, which can be severely painful once damaged. Therefore, it is often difficult for people to realize that the liver is becoming diseased, resulting in many patients delaying timely medical treatment, thus making early detection and early treatment extremely difficult for doctors, which is also one of the reasons why liver disease is difficult to detect early.
(3) Strong regenerative capacity.
Compared with other internal organs, the liver has a stronger regenerative capacity. Medical experiments have shown that after 75% of the liver was removed in mice, it could be restored to its original state after only 3 weeks, and in humans, it only takes 4 months to recover. This is certainly a blessing for patients with liver cancer that can be surgically removed, but on the other hand, the extreme regenerative capacity of the liver often causes patients to be unaware of their condition. So-called inactive chronic hepatitis can also be understood as a state in which the destruction of liver cells caused by the virus is balanced by the liver’s own ability to regenerate itself. When the degree of liver cell destruction increases and eventually exceeds the liver’s own regenerative capacity, this balance is broken, causing the overall decline of liver function and the appearance of various symptoms, but at this time the disease has been delayed for many years. Therefore, because of the liver’s “hard-working” and “silent” character, as well as its strong regenerative capacity, it is difficult to detect lesions early.
There are hundreds of millions of people infected with the hepatitis B virus in the country, and tens of millions of people with chronic hepatitis B (hepatitis B). With the development of society, the progress of science, and the attention of the Party and the State, newborns are now commonly vaccinated against hepatitis B, which plays a decisive role in controlling and eliminating chronic hepatitis B. In the future, chronic hepatitis B will be less and less. However, there are still millions of chronic hepatitis B patients in our society today, and their treatment is still a problem that has not been completely solved, resulting in many different perceptions and countless treatments, which bring misfortune to children, distress to young people, and a heavy burden to families. Thus we think it is necessary to talk about chronic hepatitis B in a light manner.
Is the hepatitis B virus highly contagious?
Hepatitis B virus (HBV) is a highly contagious virus, mainly in the following two aspects; (1) the serum contains a large amount of hepatitis B surface antigen (HBsAg), and experimental studies have found that the blood and various body fluids of hepatitis B patients contain a large amount of viral proteins, and hepatitis B surface antigen particles can be as much as 10 of 12 times/ml or more. Although infectious viral particles account for only a small fraction of this, as little as 4 X 10 of -5 times the milliliter of blood is sufficient to infect a person. This shows that the blood of hepatitis B patients is highly infectious. (2) HBV is very resistant: experimental studies have also proved that HBV is very resistant in the external environment, usually stable at 37 degrees Celsius for 60 minutes; general chemical disinfectants or heating to 60 degrees Celsius for 4 hours are unable to inactivate it; only boiling for 10 minutes or high-pressure steam disinfection at 121 degrees Celsius for 10 minutes, or heating at 65 degrees Celsius for 10 hours, it is possible to kill it Only boiling for 10 minutes or autoclaving for 10 minutes at 121°C or heating for 10 hours at 65°C can kill it. HBsAg can remain stable for 6 hours under the condition of pH 2.4, but the infectivity of the virus disappears. The titer of HBoAg-positive serum applied to plastic veneer, lead sheet, cloth sheet or paper sheet remains basically unchanged after 2 weeks at 25 degrees C and within 1 month at 6 degrees C. The titer of HBsAg-positive serum contaminated with saliva and urine can be maintained at 25 degrees C for 1 week and at 6 degrees C for 40 days, which shows its resistance to This shows the tenacity of the resistance.
Description of the five indicators of hepatitis B
（Hepatitis B is an infectious disease with a high incidence.
Hepatitis B five normal test results.
Hepatitis B surface antigen (HBsAg) – Hepatitis B surface antibody (HBSAb) – Hepatitis B e antigen (HBeAg) – Hepatitis B e antibody (HBeAb) – Hepatitis B core hangers (HBcAb) – if the above items have a positive.
2.Acute hepatitis B infection stage or chronic hepatitis B surface antigen carriers, the infection is weaker.
3, hepatitis B has tended to recover, belong to the chronic carrier, infectious weak, long-term persistence of this state can be transformed into liver cancer, 4, previously infected with hepatitis B, now still have immunity, belong to the atypical recovery period. It may also be the acute hepatitis B sensitization period.
5.Past hepatitis B infection, belongs to the acute infection recovery period, a few people still have infectious.
6.Hepatitis B infection in the past or now in acute infection.
7.Previously had hepatitis B vaccine or previously infected with hepatitis B.
8.Acute hepatitis B recovery period, previously confused with hepatitis B infection.
9, acute infection early or chronic hepatitis B surface antigen carriers are weakly infectious.
10, chronic hepatitis B surface antigen carriers are easy to turn negative or acute infection tends to recover.
11, early hepatitis B confusion or chronic carriers, highly infectious.
12.Acute hepatitis B infection tends to recover. Or chronic carriers.
The above description is for reference only, the specific situation needs to be specifically analyzed by a doctor.
What are the origins and consequences of chronic hepatitis B?
Current research has made it very clear that infection with the hepatitis B virus in young children before the age of 3 is the main cause of chronic persistent infection, mostly from the mother, but also from the father or other children, mainly through blood infection, after infection because the young child’s immune system is not yet mature, so the virus multiplies in the liver cells and is not cleared, a phenomenon medically known as immune tolerance. This infection can last for about 10 years, after the body’s immune system matures year by year, generally at the age of 13-23, the mature immune cells recognize the infected virus liver cells, so there is a reaction to remove these infected cuttings, this removal process, both to remove the virus, but also destroy the liver cells, so the serum glutathione transaminase (ALT) is elevated, usually we will In fact, this hepatitis virus was contracted as a young child, but the clearance response occurs in adulthood. Medical experts have found that because the clearance process is so complex and difficult, the body tends to clear it repeatedly, which can last for years to decades, and 30-40% of these people, because of their mild infection and their own clearance ability, usually recover without treatment by the age of 25-30, and can be completely asymptomatic or even undetected and recover. In the other 30-40% of people, the liver tissue is repeatedly damaged and repeatedly repaired due to the body’s repeated viral clearance response, which is equivalent to several times or dozens of times of hepatitis, and naturally the liver leaves a lot of “scarring”, which is usually referred to as fibrosis of the liver to varying degrees, at which time The liver’s clearance response slowly tends to be quiescent. Therefore, although the liver is damaged, but there can be no symptoms, many people do not find themselves sick, but the ultrasound and histological examination of the liver and gallbladder, can clearly see that their liver has obvious fibrotic changes, and about 20% of people due to heavy infection, the virus has mutated, the body’s clearance response is ineffective or abnormal, so that the body’s clearance response to the virus continues to develop, in the Liver fibrosis based on liver lesions continue to aggravate, appearing severe fibrosis of the liver, which is often referred to as cirrhosis. Further development then appears jaundice, ascites, hemorrhage, coma, urine less, that is, we often say that the loss of compensatory capacity after cirrhosis. This is naturally a very serious consequence, and most people are over 40 years old by then, but some of the patients we treat are only in their teens, so the progression can be fast or slow.
What does the evolution of major and minor triplets mean?
After a young child is infected with the hepatitis B virus, the virus replicates and multiplies in the liver cells, and various antigenic antibodies related to the hepatitis B virus infection can be detected in the serum, and the following are routinely detected: 1) surface antigen (HBsAg), 2) surface antibody (HBsAb), 3) E antigen (HBeAg), @E antibody (HBeAb), @anti-nuclear antibody (HBeAb). The above antigen and antibody tests are medically known as HBV-M tests (commonly known as two-and-a-half tests) and are the most important indicators to check the presence of hepatitis B virus infection. If the test is positive for items 1, 3 and 5, it is commonly referred to as the major triplet; if the test is positive for items 1, 4 and 5, it is commonly referred to as the minor triplet. During the first few years to more than ten years of hepatitis B virus infection in young children, the virus and the body “coexist peacefully” and the serum shows a major triplet, so the major triplet also reflects that the virus in the body is constantly replicating and reproducing, while the damage to the liver is usually mild at that time, a significant number of infected people, especially women, the virus can live with the body for a long time or for life. A significant number of infected people, especially women, can live with the virus “peacefully” for a long time or for life, so we call them “virus carriers”, that is, the body carries the hepatitis B virus for a long time, but the liver damage is light, can live until 50-70 years old or more, no obvious symptoms, not necessarily due to liver disease, they mainly play the role of the source of infection. More infected people at the age of 13-23, due to the maturity of the body’s immune system, can recognize the infected liver cells and appear to clear these infected liver cells, naturally this is the body’s own protective response, the result is that a large number of viruses are cleared, while the infected liver cells are also destroyed, this repeated clearance, destruction process, which is the body’s own This repeated removal and destruction process is the self-limiting healing (self-healing) process of the body itself. After several years, the virus is basically cleared, E antibodies appear in the serum, and the E antigen disappears one after another, which means that the patient changes from a major triplet to a minor triplet. It can be seen that the process of changing from major to minor hepatitis B symbolizes the basic clearance of the virus for most hepatitis B patients (except for mutant strains of infection), or basic self-healing, so that there will be no more hepatitis activity in the future, and if the infected person completes this process before the age of 25-30, then basically no cirrhosis or liver cancer will occur in the future. Unfortunately, there is still a significant proportion (about 2/3) of infected people, their own clearance response, can not completely remove the latent virus in the liver, in a number of weeks, months, years, the virus replication, clearance, liver repair week after week, so the small triplet fork to major triplet, major triplet to small triplet, and even always strong, strong, weak. The future of this part of the infected is the fibrosis of the liver to varying degrees, and some patients have developed cirrhosis at the age of about 40 years, and have developed ascites or carcinoma, and at this time, although the virus has been mostly cleared but the liver damage has been quite serious. Some patients after cirrhosis hepatitis is still active, indicating that the clearance reaction is still going on, the liver damage is still developing, the body’s own protective reaction to clear the virus, bringing more and more serious irreversible damage to its own liver tissue, and eventually can make life finally liver damage, really incredible and sad results. It can be seen that if the conversion of major triplets to minor triplets is completed before the age of 25 or 30, the process of clearing the virus is completed for the organism, and the damage to the dry organs is lighter; if the major triplets are transferred to and fro, or if the major triplets persist, and the clearance reaction (hepatitis continues to be active and the transaminases repeatedly rise) continues, then around the age of 40, for most chronic hepatitis B patients, even if they are converted to minor triplets, they all have different degree of liver fibrillation . cirrhosis or liver cirrhosis. If the hepatitis B continues for life without significant hepatitis activity (liver function is always normal), the patient may be able to live until the age of 60-70. The change from major to minor triplets is a sign that the body is clearing the virus, but the liver damage that comes with it should not be taken lightly. Therefore, it is better to turn or not to turn, and the above reasoning is understood. Our experience over the years is that as long as the liver function is normal, there is no need to enable interferon, let alone to choose those immature and scientifically unsubstantiated conversion treatment.
What is cirrhosis of the liver all about?
Cirrhosis is the structural change of the liver caused by viral hepatitis and other reasons, which over time causes the liver to become smaller and harder, and will eventually cause the liver to gradually lose its function and produce a series of symptoms of cirrhosis. The liver is composed of more than 300 billion liver cells, a large number of which are connected by a meshwork of fibers called connective tissue. When a large number of hepatocytes are repeatedly necrotic due to viral hepatitis, the destroyed hepatocytes are filled with fibrous tissue, forming so-called “scars”, and as these scars increase, even though the liver relies on its ability to regenerate itself to produce new hepatocytes, these hepatocytes are often surrounded by “scars”, forming abnormalities. When these scars increase, even though the liver relies on its ability to regenerate itself to produce new hepatocytes, these hepatocytes are often surrounded by “scars” and form abnormal pseudolobules, or “regenerative nodules”, so that the structure of the liver is changed and cannot be restored to its original state, so that the blood circulation of the liver is also changed and cannot be supplied with sufficient blood. This change is called “cirrhosis”. The main causes of cirrhosis are chronic viral hepatitis B and C, as well as alcoholic fatty liver and alcoholic hepatitis, etc. A small number of cases can also be caused by drug-related liver disease. Initially, there are usually no obvious conscious symptoms.
What are the reasons for the various manifestations of cirrhotic patients?
(1) Liver disease face guest
In patients suffering from chronic hepatitis or cirrhosis, more than 1/3 of their face and skin around the eyes are darker than before the disease, and the face is thin and withered, with small dilated blood vessels in the cheeks and dry lips, which is the “liver disease face”. Most of them think that it is due to the increase of estrogen because of the inactivation of estrogen due to the hypoactive liver function, and the increase of estrogen due to the inhibition of pituitary melanocyte stimulating hormone due to the hypoadrenocorticism, which leads to the increase of melanin production into the skin, thus presenting the face of liver disease.
(2) Spider nevus and liver palm
Patients with liver cirrhosis often have spider nevi on the face, neck, upper chest, shoulders, forearms and back of hands, which are bright red and surrounded by small radiating hair-shaped branches, most of which are 0.2~0.5 cm in diameter. This is due to diminished liver function and weakened inactivation of estrogen, which increases estrogen in the body and promotes the expansion of surrounding capillaries. The appearance of spider nevus can be a sign of chronic hepatitis or cirrhosis to some extent, but it is not specific. In addition, spider nevi can also be seen in about 40% of normal women during menstruation or pregnancy; in addition, spider nevi can also be seen in patients who have been exposed to the sun, frequently drink alcohol, have vitamin B deficiency, rheumatoid arthritis, and in a few healthy people. A manifestation of the same mechanism as spider nevus is liver palm. It means that the palm of the hand is red on both sides (large and small fissures), and there are many red spots, some of them are in the form of plaques, and the red and white are irregular, if local pressure is applied, it will become pale and return to the original state after relaxation. Sometimes patients also have this change on the soles of their feet. Because of its redness, it is also called “vermilion palm”.
(3) Jaundice
Yellowing of the sclera (white part of the eye) or skin of the patient’s eye is called jaundice in medical terminology. More than half of the patients with cirrhosis may have this sign, usually to a lesser degree. In cirrhosis, it is caused by destruction of liver cells, fibroplasia, and rupture of capillary bile ducts, which prevents normal bile drainage and increases bilirubin in the blood. If xanthogranuloma reappears or rises abruptly, both suggest that there is destruction of hepatocytes and should be taken seriously.
(4) Male breast distension and testicular atrophy.
The liver plays an important role in the balance of sex hormones in normal human blood. In cirrhosis, due to liver damage, sex hormone metabolism is disturbed, resulting in an increase in estrogen and a decrease in androgen. Due to the effect of estrogen, male patients can see breast . Enlargement, swelling and pain, and testicular atrophy. In addition, spironolactone (Ativan) is commonly used as a diuretic in cirrhotic ascites, and this drug also has the side effect of promoting breast enlargement in men. For women, too much estrogen in cirrhosis can also cause menstrual disorders, breast shrinkage, pubic hair thinning, etc.
(5) Out of stopping point, painful paralysis
Patients with cirrhosis often have a tendency to bleed, with repeated nosebleeds, gum bleeds, etc.; bleeding spots or petechiae on the skin, or in severe cases, hematomas, and these manifestations often occur without any causative factors. Under normal circumstances, coagulation factors in human body are mainly made in the liver, due to the reduced liver function in cirrhosis, the synthesis of various coagulation factors and prothrombin function is reduced; in addition, due to the enlarged spleen caused by cirrhosis, hypersplenism causes thrombocytopenia, so cirrhotic patients may have bleeding tendency.
(6) Ascites Patients with cirrhosis often develop ascites, and the early and late appearance of ascites, the amount of ascites, the duration and the number of recurrence vary from person to person. Generally speaking, the greater the amount of ascites, the greater the number of recurrences and the worse the prognosis. The reason for the appearance of ascites in cirrhosis is, firstly, the decrease of blood colloid osmotic pressure caused by the decrease of serum albumin, which makes water seep into the abdominal cavity; secondly, the increase of portal vein pressure caused by cirrhosis, which promotes the leakage of water into the abdominal cavity; in addition, the loss of balance of hepatic lymphatic fluid and poor renal function are also one of the reasons. The causes of cirrhotic ascites should be carefully investigated and active treatment measures should be taken, once combined with spontaneous peritonitis, the prognosis is extremely dangerous.
(7) abdominal wall varices The subcutaneous blood vessels of the abdominal wall are generally invisible, but with the progress of cirrhosis, different degrees of abdominal wall varices can appear, which are centered on the umbilicus, surrounded by superficial venous protrusions and expansions, shaped like earthworms, radiating in all directions, mostly seen in the upper abdominal wall. The cause is portal hypertension, the blood stagnated in the portal vein, find another way back to the heart, the abdominal wall vein is one of the ways, so cause abdominal wall varices.
(8) Splenomegaly More than half of the patients with cirrhosis have splenomegaly. Splenomegaly, like varices of the abdominal wall, is due to portal hypertension.
(9) Liver changes Early liver enlargement is mostly smooth and moderately firm; in the late stage, the liver is shrunken, firm, and has a bumpy surface, and enlarged nodules can sometimes be palpated when touched. In the early stage of cirrhosis, there is a large amount of fat infiltration and liver enlargement; in the late stage, the liver shrinks and hardens due to fatty degeneration and receding inflammatory response, reduction of liver parenchymal cells and contraction of fibrous tissue.
(10) Fever is often present in the late stage of cirrhosis, and the fever type is variable, mainly low or moderate fever, mostly between 37.5 and 38.5 degrees Celsius. This may be due to the release of substances from hepatocyte necrosis affecting the thermoregulatory center, or it may be due to the inactivation of thermogenic hormones as a result of decompensated liver function. This fever is ineffective with antibiotics and will only subside when the liver disease improves. If there is persistent high fever, most of them suggest the existence of complications; in addition, it may be accompanied by abdominal pain, which should be alerted to portal phlebitis, cholecystitis, cholelithiasis, etc. Therefore, it is important not to ignore the high fever in cirrhosis, and to find the cause for timely treatment, otherwise it will induce hemorrhage, rapid increase of ascites, liver coma, etc.
How can cirrhotic patients do a good job of family recuperation?
Liver cirrhosis is a common disease and one of the topics that has not been well solved by medical research for many years. Many patients with cirrhosis do not necessarily need to be hospitalized and rely on home rehabilitation for their long-term chronic disease. How to keep their condition stable at home is a concern for cirrhotic patients and their families. Most cirrhosis in China is caused by hepatitis. Patients with cirrhosis have a pessimistic and disappointing psychology due to their long-term illness and what they have heard and seen, and they think that once they are diagnosed with cirrhosis, the prognosis is always poor, plus there are still some cases of cancer, so they are depressed all day long. According to the performance of cirrhosis is divided into compensated cirrhosis and decompensated cirrhosis, the latter is heavy, with ascites, bleeding, liver coma, etc., need to be hospitalized, while compensated cirrhosis is the majority, can rest at home, so it is very important to establish confidence to overcome the disease. Complete recovery of diagnosed cirrhosis is impossible, but most of them have a good prognosis. The liver has a strong regenerative capacity and compensatory function, and even if 50% to 60% of normal liver cells are lost after cirrhosis, the patient can still live and work as usual. Only when about 70% of liver cells are destroyed will clinical manifestations of liver failure occur. Medical research shows that about 2/3 of patients with cirrhosis can enjoy their life, so they should not be pessimistic and disappointed. Stress, anxiety and fear can lead to immune dysfunction, which is detrimental to the recovery of the disease. Family warmth is the greatest comfort, family members should care for the patient from all aspects of life, to create a good environment for the patient to enhance their confidence in the fight against the disease.
What should be noted in the diet of cirrhosis patients during recovery?
(1) Moderate protein supplement
Patients with cirrhosis have varying degrees of hypoproteinemia, and patients often mistakenly believe that eating more protein can make up for it, but this practice of protein supplementation is sometimes harmful, because the liver is an important organ for synthesizing clear (albumin), if liver function is poor, eating more protein will not improve the amount of serum clear protein; on the contrary, excessive consumption of protein, its metabolism produces ammonia, the liver can not convert it into non-toxic substances excreted On the contrary, excessive consumption of protein, whose metabolism produces ammonia, which the liver cannot convert into non-toxic substances for excretion, will induce liver coma. Therefore, when liver function is well compensated, 2-3.5 grams of protein per kilogram of body weight per day should be given; if there are precursors of liver coma or liver coma, protein intake should be strictly limited to no more than 0.5 grams per kilogram of body weight per day. In addition, protein should not be consumed in large quantities at one time, and should be consumed in small quantities.
(2) Avoid eating hard and spicy food
Due to the liver lesion, the blood in the abdominal cavity is obstructed to return to the heart through the liver, resulting in portal hypertension, which can cause the lower esophagus and gastric fundus veins to dilate and become thicker and the walls of the vessels become thinner. If hard food is eaten, it may pierce the blood vessels and cause upper gastrointestinal bleeding. In addition, some patients with cirrhosis are often combined with gastric mucosal erosion and ulcer disease, if you eat irritating food, it will cause increased mucosal congestion and gastric peristalsis, which will not only induce bleeding, but also cause anal discomfort and aggravate anal fissures and hemorrhoids. Therefore, patients with cirrhosis should not eat too hard and spicy food, and also chew and swallow slowly at meals.
(3) Limit salt appropriately
In cirrhosis, due to the weakening of liver function, the destruction of anti-diuretics, as well as the reduction of natriuretic factor produced by the hypothalamus and liver, leads to the reduction of urine volume and the retention of water and salt in the body; in addition, the synthesis of clear protein decreases in cirrhosis, so it is easy to have swelling or ascites. Generally, the daily salt intake should not exceed 4-5 grams. In case of swelling or ascites, the salt intake should be controlled within 1 gram per day, in addition to appropriate water restriction, to avoid aggravating the condition.
(4) Do not eat too much sugar
Many people believe that liver disease is beneficial to eat more sugar, which is a misunderstanding. In liver disease, there are different degrees of abnormal sugar metabolism, the liver’s ability to use glucose is weakened, and the function of liver cells to take in glucose and synthesize glycogen is reduced, so eating large amounts of sugar for a long time can lead to diabetes, called hepatic diabetes, which makes the treatment of liver cirrhosis more difficult.
(5) You should quit sprinkling
The liver is a complex “chemical factory” in the human body, many substances are metabolized in the liver, alcohol (ethanol) is also broken down into non-toxic substances out of the body, excessive drinking will cause degeneration or necrosis of liver cells, in addition, excessive and prolonged drinking can cause alcoholic cirrhosis, so patients who have formed cirrhosis must quit drinking.