Main symptoms of patients with liver cirrhosis
The common symptoms of patients with liver cirrhosis are fatigue, abdominal distension and/or edema, muscle spasm, pain, drowsiness, sleep disorder, dry mouth, itching and appearance change. Among them, fatigue is the most common and serious symptom, while pain is the most headache for patients. In addition, with the extension of time, patients are more vulnerable to psychological symptoms, such as anxiety and depression, which will be aggravated by diseases and physical symptoms.
Treatment of liver cirrhosis
At present, the symptoms of patients with liver cirrhosis are mainly relieved by symptomatic treatment. For example, strengthening antiviral treatment of liver cirrhosis caused by hepatitis; Patients with excessive body fluids can be relieved by limiting the intake of sodium-containing diet, diuretics, abdominal puncture and ascites, and portosystemic shunt. These measures can relieve abdominal distension. You may ask whether there is any specific medicine for liver cirrhosis (essentially liver fibrosis), but unfortunately there is no specific medicine in western medicine. There are many TCM anti-fibrosis treatments in the literature, but because TCM pays attention to syndrome differentiation and treatment, it dare not recommend them rashly.
Problems needing attention in patients with liver cirrhosis
1. Diet: Patients with liver cirrhosis generally have poor appetite and decreased digestive function. Therefore, it is necessary to arrange the diet of patients with liver cirrhosis reasonably, ensure the reasonable nutrition of patients, enhance their physique and prevent complications. Due to the different degree of liver function damage in patients with liver cirrhosis, they have different dietary requirements, but the principles they follow are the same: ensuring sufficient heat energy, avoiding eating high animal protein, taking plant protein as the main component, and adjusting the distribution and supply of protein in time according to the change of illness. Supplementing fruits properly, keeping defecation unobstructed, and supplementing vitamins properly.
2. Be alert to serious complications:
(1) Gastrointestinal bleeding: Gastrointestinal bleeding is one of the most serious and common complications of decompensated cirrhosis. Close observation, timely identification and early treatment are very important links in the nursing process. Patients with melena often suggest that the amount of bleeding is 50~80 ml, and hematemesis often suggests that the blood volume in the stomach is 250~300 ml. Changes in pulse and blood pressure can also indicate the degree of bleeding. If the pulse is 20~30 beats/min faster than the basal heart rate, the patient will have thirst, dizziness, cold sweat, nausea, accelerated pulse, palpitation, decreased blood pressure and small pulse pressure difference, indicating that the amount of bleeding is above 1000 ml. Therefore, patients with liver cirrhosis should pay special attention to their diet and avoid foods that are irritating to the gastrointestinal tract.
(2) Hepatopulmonary Syndrome: It is a serious pulmonary complication in patients with liver cirrhosis, and its main clinical manifestations are dyspnea and cyanosis. It is best for patients to change their postures frequently during bed rest, so as to improve the local gas exchange in the lungs, avoid strenuous exercise and sudden rapid standing up, prevent orthostatic dyspnea and relieve hypoxemia.
(3) Hepatic encephalopathy: refers to the neuropsychiatric syndrome secondary to central nervous system dysfunction in patients with severe liver disease, including the whole process from mild neuropsychiatric symptoms to deep coma. Early personality changes, silence, irritability or indifference; With the further progress of the disease, there may be insanity, abnormal movement and disorientation, which are mainly manifested as confusion of time, place and characters and flapping wing tremor; In severe cases, it will develop into lethargy and coma. Hepatic encephalopathy is the most serious complication in patients with decompensated cirrhosis. Family members of patients should strengthen the observation of patients' condition, find hepatic encephalopathy as soon as possible and strive for early intervention. What patients can do is to keep the stool unobstructed and prevent constipation, because constipation makes toxic substances such as ammonia stay in the intestine for too long, which will promote the absorption of toxins.
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refer to
Dong Ning, Wang Lin, Yan Lu, Zhang Lin, Bao Meijuan, Lu Hongzhou. Symptom experience and management of patients with liver cirrhosis [J]. Nursing Research, 2017,31(20): 2437-2440.
[2] Zhang Chunli, Jin Xiaoying, Yuan Ying. Advances in nursing research on complications of liver cirrhosis [J]. ordinary care, 20 18, 16 (23): 2862-2866.
At present, the incidence of cirrhosis in China is relatively high, and the mortality rate is relatively high. In the later stage, liver function may decrease and portal hypertension may increase, and various complications may occur. The course of the disease develops slowly, mainly in male patients, and there may be diffuse fibrosis, regenerative nodules and false lobules in the liver. In China, viral hepatitis is the main manifestation, with hepatitis B and hepatitis C as the main manifestations. Some stem cells invaded by hepatitis are widely degenerated and necrotic, and lobular formation has liver cell regeneration disorder.
Hepatic fibrosis is also an important stage in the evolution of liver cirrhosis. The extracellular matrix of normal liver tissue is degraded and kept in balance. If liver cells are activated when the liver is injured, a variety of cytokines will be transformed into endothelial cells with the participation of the school.
The treatment of liver cirrhosis is a comprehensive treatment of the etiology, which needs to be aimed at the primary disease, especially the acute stage. If there are acute symptoms or life-threatening diseases, it is generally necessary to seek medical attention in time, including general treatment, diet and rest, especially for patients with ascites, who can be in compensatory period, and must stay in bed when complications occur. During the compensatory period of liver cirrhosis, they can take part in light labor activities.
Diet should be based on foods with high cellulose and easy digestion and absorption, and eat more fresh fruits and vegetables. The intake of salt and water needs to change according to the illness. Once complications of esophageal and gastric varices occur, don't eat too hard and rough food.
In the compensatory period of liver cirrhosis, antiviral drugs are the first choice, which have strong antiviral effect and low drug resistance. You can also choose other drugs to treat liver cirrhosis, mainly symptomatic treatment. For example, if ascites patients have a lot of edema, diuretics can be used in combination when necessary, because hypoproteinemia requires infusion of serum protein, and if there is bacterial infection, antibiotics are needed.
Surgical treatment is also some of the most commonly used treatments to evaluate risks and complications, and it needs to be tested according to specific vital signs.
But at present, liver transplantation is also a kind of cirrhosis caused by many reasons. The purpose of liver transplantation is to effectively relieve symptoms, especially the symptoms of static diseases, especially some esophageal and gastric varices may need hemostasis surgery. When ligation is difficult, safer conservative drugs will be chosen for treatment.
Liver cirrhosis is mostly caused by long-term chronic drinking of hepatitis B and C, so we should pay attention to the following reasons.
1. Do not smoke or drink, and maintain good living habits. Long-term drinking may lead to the formation of false blood and alcoholic cirrhosis, causing serious damage to liver cells. Eat a low-sugar and low-salt diet, try to eat less coffee and drinks, pay attention to rest and avoid staying up late.
2 If there are hepatitis B and hepatitis C, there may be liver function damage. It is necessary to protect the liver in time, treat the symptoms, and reduce liver function damage. At the same time, quantitative DNA examination was done with hepatitis C alpha-fetoprotein and hepatitis B to see if there was replication and infectivity, and the changes of abdominal color Doppler ultrasound were monitored.
3. If transaminase is found to be elevated, you need to use liver protection drugs, but you can't use too many liver protection drugs, which is prone to the process of digital medication of liver function. It also depends on whether some drugs are harmful to the liver, and drugs that are harmful to the liver should be stopped or not used in time.
4. Reduce infection, because patients with low liver function or liver cirrhosis will have induced infection due to low immunity, develop good living habits and wash their hands frequently. If there are hepatitis B and hepatitis C, the primary disease needs timely treatment, including some flu vaccines, which need to be vaccinated in time.
5. If liver cirrhosis is definitely diagnosed, you should be cautious in using drugs, especially if you need to consult a doctor before using any drugs to avoid using some drugs with relatively high hepatotoxicity. This situation can easily increase the ascites of the liver and often affect the absorption and metabolism of the liver.
The treatment of liver cirrhosis should first understand what liver cirrhosis is and how it is formed. We know that there is liver cirrhosis because the liver is affected by various reasons, including viral hepatitis, drinking, fatty liver, drug-induced, autoimmune, hereditary, metabolic and other diseases, which lead to repeated inflammation of liver cells and start the process of liver fibrosis, just like people's skin will grow scars when they have wounds. Repeated inflammation of the liver will also lead to scars, and repeated accumulation of scars will lead to gradual hardening and atrophy of the liver, forming false lobules, which is called cirrhosis. Then understand the formation of liver cirrhosis, we can understand that the treatment of liver cirrhosis is based on the etiology treatment, combined with the application of anti-fibrosis drugs to prevent liver scarring, and then further reverse or disappear the already long scar, liver cirrhosis can be improved or reversed. According to the etiology of treatment, including hepatitis B patients should use antiviral drugs to control virus replication and prevent repeated fluctuations in liver function. At present, patients with hepatitis C can be completely cured by directly removing the virus, and then find ways to improve liver cirrhosis. Patients with drug-induced liver injury must be prohibited from using drugs that damage the liver. Alcoholic cirrhosis should pay attention to strict abstinence from alcohol and strengthen nutrition. Metabolic cirrhosis should pay attention to controlling weight and improving metabolism. Autoimmune cirrhosis requires long-term use of drugs, such as hormones or ursodeoxycholic acid capsules. Other reasons should be handled according to different situations. On the basis of controlling the etiology, anti-fibrosis drugs were used. Therefore, there are no anti-fibrosis drugs in western medicine at present, and Fuzheng Huayu Pill and Luo 'an Huaxian Pill used in western medicine are all Chinese patent medicines. Anti-hepatic fibrosis treatment is precisely the advantage of traditional Chinese medicine. Traditional Chinese medicine can completely improve and reverse liver cirrhosis by invigorating qi and strengthening body resistance, promoting blood circulation and removing blood stasis. But this matter should not be rushed. The formation of liver cirrhosis takes 5- 10 years, so elimination is also a cumulative process, ranging from a few years to more than ten years. It is most important to cultivate good compliance, insist on treatment and review regularly.
Daily attention to liver cirrhosis includes 1, avoiding folk remedies and indiscriminate medication. For patients with liver cirrhosis, it is counterproductive to use only useful drugs to avoid increasing the burden on the liver. Because of the doctor's customized treatment plan, we know whether the drug has side effects on patients, as well as the name, dosage and time of taking the drug. Don't blindly take drugs, let alone listen to the so-called folk remedies in the Jianghu.
2. Avoid burning food and hard food. Patients with liver cirrhosis should eat less food such as barbecue, especially burnt food and hard food. Remember not to eat. Portal hypertension in patients with liver cirrhosis leads to thickening of blood vessels at the bottom of stomach and thinning of stomach wall. If hard food is swallowed without chewing, it is likely to scratch blood vessels and cause gastrointestinal bleeding.
3. Avoid spicy food. Portal hypertension in patients with liver cirrhosis leads to thickening of blood vessels at the bottom of stomach and thinning of stomach wall. If patients eat spicy food, it will lead to gastric mucosal erosion, gastric ulcer and gastric bleeding.
4. Avoid alcohol and tobacco. It is certain that patients with liver cirrhosis will get worse if they smoke. Of course, if there is cirrhosis in their family, other members should also quit smoking or avoid smoking. Secondhand smoke is more harmful than smoking yourself. Of course, alcohol is also very harmful to patients, so all patients with food that can damage the liver should pay attention.
5, avoid excessive salt. The liver of patients with liver cirrhosis destroys the function of antidiuretic, so the urine volume decreases, which makes the salt stay in the body, the plasma protein decreases, and edema or ascites occurs. Therefore, patients with liver cirrhosis should strictly control the intake of salt. If there is no edema or mild edema in liver cirrhosis, eat no more than 5 grams of salt every day; For those with severe edema, the salt intake should not exceed1g.
Cirrhosis is the terminal stage of chronic, progressive and diffuse liver disease caused by various reasons, which acts on the liver for a long time. Epidemiological investigation shows that liver cirrhosis accounts for about 50% of all patients with liver diseases, and the mortality rate is about 10%, which is the second highest mortality disease after liver cancer.
How to treat liver cirrhosis?
The treatment of liver cirrhosis is very important, but there are no specific methods and drugs at present, which mainly aim at the cause to relieve symptoms.
1. Antiviral therapy
At present, the main cause of liver cirrhosis in China is viral hepatitis, among which hepatitis B virus infection is the most common cause. For patients with liver cirrhosis with active virus replication, it is mainly the control treatment of hepatitis B virus. At present, the commonly used drugs in clinic are mainly nucleoside analogues such as entecavir and lamivudine.
2. Integrated traditional Chinese and western medicine therapy
Drugs for promoting blood circulation and removing blood stasis can inhibit liver cirrhosis caused by hepatitis B, and play an important role in inhibiting chronic hepatitis B fibrosis and treating hepatitis B cirrhosis. Some literatures recommend integrated traditional Chinese and western medicine therapy, but there is still a lack of more comprehensive basis.
3. Liver protection treatment and symptomatic support treatment
The drugs that protect hepatocytes are ursodeoxycholic acid and polyene phosphatidylcholine. Although liver-protecting drugs have a certain pharmacological basis, they lack evidence-based medical evidence, and taking more drugs will increase the burden on the liver. Patients with liver cirrhosis often lack albumin and have systemic edema, so albumin and immune enhancers can be supplemented appropriately.
The treatment of liver cirrhosis lies in early detection and early treatment. For drugs with unclear curative effect, don't take them blindly, otherwise it will increase the burden of liver metabolism.
Liver cirrhosis is actually a long-term massive damage to liver cells, replaced by fibrous tissue. Once formed, it is difficult to reverse. The sooner you find out, the lighter the damage, and the more likely it is to be reversed. For liver cirrhosis, there is no specific medicine, mainly based on etiological treatment, supplemented by anti-hepatic fibrosis drugs, severe liver cirrhosis, but also to prevent complications.
First, the definition of cirrhosis:
Cirrhosis is the end stage of liver caused by long-term effects of various reasons.
On the basis of extensive necrosis of hepatocytes, the normal structure and blood supply of hepatic lobules are destroyed and replaced by regenerative nodules and pseudolobules formed by fibrous tissue proliferation.
If the disease continues to advance to the advanced stage, there will be liver failure, portal hypertension and various complications, and the mortality rate is extremely high.
Second, according to the definition of liver cirrhosis, determine the treatment measures of liver cirrhosis:
(1) Treat according to the cause to prevent the disease from progressing;
Solve the cause of liver cirrhosis, such as antiviral treatment of hepatitis B and hepatitis C; Abstinence from alcohol due to fatty liver and alcoholic hepatitis; Avoid taking drugs harmful to the liver for a long time.
(2) Anti-fibrosis therapy for fibrous tissue hyperplasia:
So far, there is no effective method to reverse liver fibrosis. Interferon, Compound Biejia Ruangan Tablet, Biejia Wan Jian, Fuzheng Huayu and Luo 'an Huaxian have certain anti-hepatic fibrosis effects, which are suitable for patients with early cirrhosis.
(3) Prevention and timely detection of complications in patients with advanced cirrhosis:
The common complications of liver cirrhosis include ascites, hepatic coma, upper gastrointestinal bleeding, peritonitis, liver cancer, hepatorenal syndrome and so on.
(4) Note:
① Patients with early cirrhosis can take part in light manual labor; Patients with advanced cirrhosis, especially those with complications, should stay in bed.
② Cirrhosis is a consumptive disease. Basic nutrition should be guaranteed, high-vitamin and digestible food should be given, and drinking is prohibited. Lean meat, fish, bean products, milk, soybean milk, vegetables and fruits can be eaten. Patients with esophageal varices should fast hard and rough hand food, and the intake of salt and water should be adjusted according to the patient's situation.
③ Patients with ascites due to liver cirrhosis, upper gastrointestinal bleeding and hepatic coma should be hospitalized.
Dr Duan specially reminded:
(1) The etiology of liver cirrhosis is complicated. At present, hepatitis B is the most common in China, followed by alcoholic hepatitis. Patients with hepatitis B should be actively treated with antiviral therapy.
(2) Cirrhosis cannot be formed in a day or two, a month or two, or a year or two, and it takes several years. Therefore, patients with long-term liver injury should be actively treated to prevent cirrhosis.
(3) Life expectancy will not be affected until early cirrhosis is controlled.
(4) Color Doppler ultrasound and liver function are the main screening items to detect liver injury and cirrhosis. It should be done regularly, especially for people with long-term liver damage.
Pay attention to Dr. Duan, healthy and healthy!
Looking for the cause of liver cirrhosis, the most common liver cirrhosis in China is caused by hepatitis B, and there are other causes, such as hepatitis C, schistosomiasis, autoimmune diseases, hereditary diseases and so on.
The treatment of liver cirrhosis should first be based on the cause. For example, hepatitis B cirrhosis needs antiviral treatment before it can be treated. Early cirrhosis can be reversed, while middle and late cirrhosis can only maintain liver function, treat complications and delay the course of disease.
If liver cirrhosis has been diagnosed, it is recommended to go to public hospitals and tertiary hospitals, and don't buy medicine yourself, so as not to delay the disease and accelerate its development.
Liver cirrhosis is mainly due to qi deficiency and blood deficiency, blood deficiency and excessive water, which is a syndrome of excess and deficiency. Liver cirrhosis ascites is mostly chronic hepatitis, and liver failure is extremely serious. Sheep liver is an important detoxification organ. Liver failure cannot be detoxified, and toxic substances will further poison organs such as liver and kidney, leading to systemic failure of the human body. Treatment only considers supplementing qi and nourishing blood, removing blood stasis and promoting diuresis. Clinical treatment methods are supplementing qi and nourishing blood, nourishing and protecting liver, removing blood stasis and promoting blood circulation, softening and resolving hard mass, eliminating hepatosplenomegaly and ascites edema. After a period of treatment, liver function tends to be normal, and it is hoped that liver cells will regenerate. Commonly used prescriptions: 1 Huo Ling drink plus Wuling Gao Danggui Shaoyao powder, 2 Xiaochaihu decoction plus Wuling powder plus Chen Yin. But it needs dialectics! According to the different symptoms of each patient, the above prescriptions were treated with addition and subtraction, and good results were achieved.
The best effect is to prepare medicine at home. Dosage and usage are the key!
Chinese medicine is the best treatment, but western medicine is not, that is a waste of money.
Many times, there are always many crossroads in our lives. Which university to choose, when to fall in love, when to get married, and how to arrange your career? These things actually give you the opportunity to choose in advance, such as what kind of eating habits to choose. There are two ways to choose, one is to live and the other is to die.
There are many people with liver cirrhosis, but they take different paths. What are the reasons and how can we avoid the threat of disease?
Liver cirrhosis is caused by many factors, such as viral hepatitis, fatty liver, alcoholic hepatitis and cholestasis. , leading to structural changes in the liver. As the largest digestive organ in our body, adjusting diet plays a vital role in preventing complications and rehabilitation of liver cirrhosis.
Now let's take a closer look at these questions:
First of all, we should know that beef is a kind of red meat. If cooked improperly, it may produce a lot of harmful toxins. This kind of carcinogen is mainly heterocyclic amine, and its production is closely related to cooking temperature. When the cooking temperature exceeds 200, red meat may produce a lot of heterocyclic amines, such as the barbecue we often eat.
If it can't be absorbed and metabolized smoothly, this substance may not be deposited in our body, resulting in poor metabolism of liver detoxification system and some pathological changes, and the data of alkaline phosphatase in the body will soar. If we don't pay attention to ourselves at ordinary times, it may be worse.
Preparing these two tricks may help you find out in time, nourish and protect your liver:
Cirrhosis often happens inadvertently, but it is not without a trace. Prepare 2 tricks to nip cirrhosis in the cradle.
The first trick: don't give up conditioning the liver:
Many times, these two things may be the best in daily conditioning. Selenium malt and Schisandra chinensis. Because selenium malt is difficult to buy, selenium malt and Schisandra chinensis on the market are basically mashed and the ingredients are stripped. Selenium is extracted from selenium malt, lignans and schisandrin A are extracted from Schisandra chinensis, and then repeatedly purified by high technology, and then refined into tablets with the purified components.
Selenium in selenium malt can scavenge free radicals, repair liver injury, restore liver function, restore metabolic function, dredge blocked biliary tract, and metabolize and excrete alkaline phosphatase normally. Schisandra chinensis contains lignans and schisandrin A, which can inhibit free radicals, repair liver cells and promote glycogen production.
The second measure: don't ignore the number of physical examination indicators:
In fact, when you feel uncomfortable, the process of going to the hospital for physical examination is also very good. Routine blood tests that can detect physical problems, such as alkaline phosphatase in the index, can be said to be very clear about cirrhosis. If the increase is obvious, it means that the liver has been seriously damaged.
Alkaline phosphatase is a kind of phosphomonoesterase. The alkaline phosphatase in serum comes from different tissues (liver, bone, kidney, small intestine, placenta and so on). ), its normal reference value is: female 50 65 438+0 35 U/L; Male 45 125U/L, if it exceeds this range, you should pay attention to your health.
Now let's learn more about protein, lipids and salt:
1, appropriate amount of protein: If patients with liver cirrhosis do not feel trance or drowsiness, or feel discomfort symptoms such as weakness of limbs and flatulence in abdomen, protein intake should not be excessively restricted, and protein intake can be maintained in a normal diet (about 70g per day) to avoid nutritional deficiency. However, if the above symptoms occur, the intake of animal protein, plant protein (beans, cereals, nuts, etc.) should be reduced as much as possible. ) should be changed to avoid the metabolism of nitrogen-containing waste that cannot be excreted and increase the burden on the liver.
2, the right amount of lipids: Many patients with liver cirrhosis will suffer from bile duct diseases at the same time, or accompanied by hyperlipidemia. If you eat too much fat, it is not only difficult to digest and absorb, but also easy to cause liver fat accumulation.
But many vitamins are fat-soluble, such as vitamins A, D, E, K and so on. Excessive restriction of fat intake will also lead to vitamin deficiency and some complications. Generally speaking, patients with liver cirrhosis should not consume more than 50 grams of fatty food every day, including animal meat and edible oil.
3. Appropriate amount of salt: Salt intake will cause fluid retention in patients with liver cirrhosis, especially in patients with ascites and edema, and there is usually a problem of excessive salt intake (so the lower limit of salt should be guided by doctors). However, too strict restriction on salt force will not only cause electrolyte disorder, but also weaken the barrier function of gastric mucosa due to chloride ion deficiency and induce gastric ulcer.
Generally speaking, if there is no ascites or edema, the salt intake of patients with liver cirrhosis should be controlled at 2~4 grams per day.
At this time, it is a good thing to choose medical treatment or enter the next stage of clear examination. If you don't pay attention yourself, you may infect your liver with a virus.