肝硬化与肝癌
Cirrhosis and liver cancer are two majorliver酗酒的个体遇到的病理学。两种情况都是威胁生命的条件。最初,它们可能具有类似的特征,但是在临床角度以及在患者侧面了解两者之间的基本差异非常重要,因为癌症是个坏消息。本文介绍了肝硬化和肝癌的临床特征,症状,病因,研究和诊断以及预后,并概述了肝硬化和肝癌之间的差异以及所需的治疗方法。
Cirrhosis
Cirrhosis means irreversible liver damage. Under the microscope, cirrhotic liver has damaged warped liver architecture with excessive fibrosis and nodular regeneration. Chronic alcohol abuse, autoimmune diseases, genetic disorders (Wilson’s disease, hemochromatosis, alfa antitrypsin deficiency), drugs (amiodarone, methyldopa and methotrexate), Budd-Chiari syndrome,hepatitis B and hepatitis C是肝硬化的一些众所周知的原因。肝硬化可能是无症状的,肝酶的简单升高或肝功能衰竭。白色指甲,特里的指甲(白色近端半和红色的远端),指甲俱乐部,黄疸腮腺肿胀,男性乳腺癌的扩大,帕尔马r redness, hand contractures (Dupuytren’s), bilateral pitting ankle edema, small testes (testicular atrophy), and enlarged liver (in early disease) are the common clinical features of hepatic cirrhosis.
With chronic liver disease, a whole lot of complications can manifest themselves.Clottingabnormalities (because liver produces most of the clotting factors), encephalopathy (due to impaired ammonia metabolism), low blood sugar (due to poorglycogen肝脏的代谢),自发细菌性腹膜炎和门户高血压are a few examples. Encephalopathy presents with coma, confusion, day-night reversal, flapping hand tremors, poor stereognosis (spatial awareness). Portal hypertension leads to esophageal varices (hematemesis and melena), enlargedspleenand Caput medusa.
Full blood count, blood urea, serumcreatinine, liver enzymes including gamma GT, direct and indirectbilirubin, serum白蛋白, bleeding time, clotting time, virology for hepatitis, autoantibodies, alfafetoprotein, caeruloplasmin, alfaantitrypsin, and ultrasound scan of theabdomen是常规调查。如果首次检测进行评估和肝脏疾病,应将患者入院。一般管理包括,每日体重图,blood pressure and heart ratemonitoring,urineoutput,serum电解质,腹腔,QHT,检查胸腔积液,腹膜炎引起的腹部嫩腹。饮食应为低盐和低蛋白质。可以给出抗生素以冲洗ammoniaforming gut bacteria in case of liver failure and to treat bacterial peritonitis. Diuretic remove fluid. Ascitic tap removes excessive fluid collection in the peritoneal cavity. Interferones, ribavirin, and penicillamine have their roles according to the clinical presentation.
Liver Cancer
The commonest types of hepatocellularcarcinomaare not actually from the liver but from breast,bronchus,and gastrointestinal tract. They are in essence metastatic deposits. Primary肿瘤arising from the liver may be良性或恶性. Cancer in the liver may present with fever, malaise,anorexia, nausea, vomiting, jaundice, liver enlargement, and general features of chronic liver disease. Tests done in chronic liver disease and chest x ray, CT abdomen, and bone marrow biopsy may be done in case of a hepatocellular carcinoma, as well. Viral hepatitis, cirrhosis, aflatoxin, and parasites may cause liver cancers. Surgical resection of solid tumors, chemotherapy, and radiotherapy are the treatment options available. Hepatocellular carcinoma is a deadly disease with >95% 5 year mortality.
What is the difference between Cirrhosis and Liver Cancer?
• Cirrhosis is liver fibrosis and regeneration while liver cancer is an abnormal uncontrolled growth in the liver.
• Cirrhosis affects the liver completely while cancers are initially localized.
•肝硬化的变化均匀地散布在肝脏中,而癌症则以小结节生长的形式扩散。
• Cirrhosis is a cause of liver cancers.
• Cirrhotic parts cannot be excised, but cancers can be removed by partial liver resection.
• Cirrhosis has an excellent prognosis if managed properly while liver cancer has very bad prognosis.
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