吉林市中心医院就诊肝硬化患者病因及临床特征分析

发布时间：2018-02-07 13:20

本文关键词： 肝硬化病因临床特点病毒性肝炎　出处：《延边大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的收集并分析吉林市中心医院肝硬化住院患者的病因特点、临床分析及并发症转归。方法回顾性分析吉林市中心医院从2003年1月至2012年12月住院期间确诊的1238例肝硬化患者临床资料及实验室检查情况、后期并发症转归。结果共收集肝硬化患者1238例,女性368例,男870例；年龄分布在17-79岁。其中乙型肝炎相关性肝硬化669例(54.04%)、酒精性肝硬化226例(18.26%)、丙型肝炎肝硬化213例(17.77%)、胆汁淤积性肝硬化52例(4.20%)、乙肝合并酒精肝硬化39例(3.15%)、隐源性肝硬化22例(1.70%)、自身免疫性肝硬化12例(0.97%)、。其它原因所致的肝硬化比例较低,包括布-加综合症1例、心源性肝硬化4例。1238例肝硬化患者中894(72.23%)例出现并发症,其中原发性腹膜炎358例(28.93%)最多,其次为上消化道出血182例(24.67%)。肝硬化并发肝癌140例(22.59%)。乙肝标志物阳性的肝癌占54.8%。住院期间死亡病例92例,其中上消化道出血占35.2%,肝性脑病死亡占33.03%,原发性腹膜炎7.14%,三种并发症构成肝硬化死亡的主要原因。结论 1.吉林市近10年来肝硬化的主要病因仍是以乙型病毒性肝炎为主,远超过其他原因引起的肝硬化。其次为酒精性肝硬化和丙型肝炎相关性肝硬化； 2.肝硬化患者多表现为慢性病容、腹胀、肝掌、黄疸和蜘蛛痣等症状和体征。 3.大部分乙型肝炎相关性肝硬化合并肝癌患者AFP升高不明显,应定期对病毒性肝炎及相关性肝硬化患者随访AFP和影像学检查,早期发现肝癌等严重并发症并及时进行针对性治疗。 4.本地区肝硬化死因仍以上消化道出血最常见,其次为肝性脑病,注意针对性防治,降低死亡率。 5.肝硬化是我国常见疾病和主要死亡病因之一,可以针对患者病因做到早期发现,积极治疗。病毒相关性肝硬化患者能够积极进行长期持续抑制或清除病毒,进一步减轻肝硬化患者各种并发症的出现。对于酒精性肝硬化患者注意戒酒,防止酒精做为单独或协同其他致病因素对肝脏能够造成严重损伤,从而减少肝硬化及其并发症的发生。
[Abstract]:Objective to collect and analyze the etiological characteristics, clinical features and complications of inpatients with liver cirrhosis in Jilin City Central Hospital. Methods the clinical data and laboratory findings of 1238 patients with liver cirrhosis diagnosed from January 2003 to December 2012 in Jilin City Central Hospital were retrospectively analyzed. Results A total of 1238 patients with liver cirrhosis were collected, 368 females and 870 males. The age distribution ranged from 17 to 79 years old, including 669 cases of hepatitis B associated cirrhosis, 226 cases of alcoholic cirrhosis, 213 cases of hepatitis C cirrhosis, 52 cases of cholestasis cirrhosis, 39 cases of hepatitis B complicated with alcoholic cirrhosis and 3.15% of cryptogenic liver cirrhosis, respectively. In 22 cases, 1.70% and 12 cases of autoimmune cirrhosis, 0.97% and 0.97%, respectively. The proportion of liver cirrhosis caused by other causes was relatively low. Including 1 case of Budd-Chiari Syndrome, 4 cases of cardiogenic cirrhosis, 1238 cases of liver cirrhosis, 894 cases of liver cirrhosis and 72.23 cases of complications, of which 358 cases of primary peritonitis (28.933%) are the most. The second was upper gastrointestinal hemorrhage (182 cases), liver cirrhosis complicated with liver cancer (140 cases), hepatitis B marker positive liver cancer (54.8B), and dead cases (92 cases) during hospitalization. The hemorrhage of upper digestive tract accounted for 35.2cm, the death rate of hepatic encephalopathy was 33.03.The primary peritonitis was 7.14%. Three kinds of complications constituted the main cause of death of liver cirrhosis. Conclusion. 1. The main etiology of cirrhosis in Jilin City in the past 10 years is mainly caused by viral hepatitis B, which is much higher than that caused by other causes, followed by alcoholic cirrhosis and hepatitis C related cirrhosis. 2. The symptoms and signs of chronic disease, abdominal distension, liver palms, jaundice and spider nevus were found in patients with liver cirrhosis. 3. The increase of AFP was not obvious in most patients with hepatitis B associated cirrhosis and liver cancer. AFP and imaging examination should be regularly followed up in patients with viral hepatitis and associated cirrhosis. Early detection of liver cancer and other serious complications and timely targeted treatment. 4. The most common cause of death of liver cirrhosis is digestive tract hemorrhage, followed by hepatic encephalopathy. Attention should be paid to prevention and treatment to reduce mortality. 5. Liver cirrhosis is one of the common diseases and major causes of death in China. To further reduce the occurrence of various complications in patients with cirrhosis of liver. For patients with alcoholic cirrhosis, pay attention to abstinence from alcohol and prevent alcohol from causing serious damage to the liver, either alone or in conjunction with other pathogenic factors. In order to reduce the incidence of cirrhosis and its complications.
【学位授予单位】：延边大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R575.2

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