本文關鍵詞： 肝硬化 病因 臨床特點 病毒性肝炎　出處：《延邊大學》2014年碩士論文　論文類型：學位論文

【摘要】：目的收集并分析吉林市中心醫(yī)院肝硬化住院患者的病因特點、臨床分析及并發(fā)癥轉歸。 方法回顧性分析吉林市中心醫(yī)院從2003年1月至2012年12月住院期間確診的1238例肝硬化患者臨床資料及實驗室檢查情況、后期并發(fā)癥轉歸。 結果共收集肝硬化患者1238例,女性368例,男870例；年齡分布在17-79歲。其中乙型肝炎相關性肝硬化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%)、膽汁淤積性肝硬化52例(4.20%)、乙肝合并酒精肝硬化39例(3.15%)、隱源性肝硬化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較低,包括布-加綜合癥1例、心源性肝硬化4例。1238例肝硬化患者中894(72.23%)例出現(xiàn)并發(fā)癥,其中原發(fā)性腹膜炎358例(28.93%)最多,其次為上消化道出血182例(24.67%)。肝硬化并發(fā)肝癌140例(22.59%)。乙肝標志物陽性的肝癌占54.8%。住院期間死亡病例92例,其中上消化道出血占35.2%,肝性腦病死亡占33.03%,原發(fā)性腹膜炎7.14%,三種并發(fā)癥構成肝硬化死亡的主要原因。 結論 1.吉林市近10年來肝硬化的主要病因仍是以乙型病毒性肝炎為主,遠超過其他原因引起的肝硬化。其次為酒精性肝硬化和丙型肝炎相關性肝硬化； 2.肝硬化患者多表現(xiàn)為慢性病容、腹脹、肝掌、黃疸和蜘蛛痣等癥狀和體征。 3.大部分乙型肝炎相關性肝硬化合并肝癌患者AFP升高不明顯,應定期對病毒性肝炎及相關性肝硬化患者隨訪AFP和影像學檢查,早期發(fā)現(xiàn)肝癌等嚴重并發(fā)癥并及時進行針對性治療。 4.本地區(qū)肝硬化死因仍以上消化道出血最常見,其次為肝性腦病,注意針對性防治,降低死亡率。 5.肝硬化是我國常見疾病和主要死亡病因之一,可以針對患者病因做到早期發(fā)現(xiàn),積極治療。病毒相關性肝硬化患者能夠積極進行長期持續(xù)抑制或清除病毒,進一步減輕肝硬化患者各種并發(fā)癥的出現(xiàn)。對于酒精性肝硬化患者注意戒酒,防止酒精做為單獨或協(xié)同其他致病因素對肝臟能夠造成嚴重損傷,從而減少肝硬化及其并發(fā)癥的發(fā)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.
【學位授予單位】：延邊大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R575.2

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