Friday, August 15, 2008
Early diagnosis of cirrhosis
(A) diagnosis Decompensated cirrhosis of the diagnosis is not difficult, but early diagnosis is difficult. Pathology identified as patients with cirrhosis, without any symptoms, or only some non-specific symptoms of the digestive tract, so simply rely on clinical symptoms difficult to make early diagnosis. The following points may help early diagnosis: 1. For viral hepatitis, chronic lack of long-term drinking, such as patients with chronic gastro-intestinal infection, we must closely follow-up study with a view to early diagnosis. 2. For reasons unknown hepatomegaly, especially liver texture is a solid, smooth surface, to adopt various methods including ultrasound, laparoscopic, such as liver biopsy to determine their nature. Both the liver and spleen, liver cirrhosis is more likely. (B) the differential diagnosis to consider the differential diagnosis 1. Hepatomegaly caused by other reasons, such as chronic hepatitis and primary liver cancer and liver fat infiltration, and so on. 2. Splenomegaly caused by other reasons, especially the so-called idiopathic portal hypertension (grouper for the syndrome), its pathology of the liver before sinus portal fibrosis and increased pressure, clinical performance as splenomegaly, Anemia, WBC and thrombocytopenia, gastrointestinal bleeding, and so repeatedly. Advanced schistosomiasis have sinus before obstruction of the liver and portal hypertension, hypersplenism and ascites, and other performance, attention should be paid differential. 3. With other causes of upper gastrointestinal bleeding, in particular, peptic ulcer, gastritis, and so on. 4. And other causes of ascites, in particular the narrow pericarditis, Tuberculosis peritonitis, peritoneal cancer and ovarian cancer. Ovarian cancer in particular, is false mucinous cystadenocarcinoma, often chronic ascites as the main performance, ascites for the leakage of liquid in nature, can sometimes cause difficulties on the differential diagnosis, diagnostic laparoscopy on helpful. 5. And other causes of psychiatric symptoms such as uremia, diabetic ketoacidosis caused by a coma, with the identification of hepatic encephalopathy. Early cirrhosis of the clinical symptoms and diagnosis Cirrhosis of the past generally wait until a ascites, such as gastrointestinal bleeding or a loss can be compensated performance of the diagnosis, the treatment of this often lose the opportunity. Now, have a lot of liver fibrosis and biochemical indicators, such as Ⅰ, Ⅱ, Ⅲ, Ⅳ collagen, collagen, laminin, HA, such as biochemical indicators of the hospitals in different ways, normal Values are also different, but these indicators increased, on the tips of early liver cirrhosis, early treatment of liver fibrosis.
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