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 terminal phase of the curve

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PostSubject: terminal phase of the curve   Fri Apr 06, 2007 1:57 pm

For phase II clinical characteristic symptoms : nemotivirovannaya weakness, demanded despepsiceskie disorders, and the emergence of progressive jaundice, bloody diateza, aszita sometimes gipoproteinemicakih eye. Laboratory studies showed significant deviations from the norm in many or all liver samples; Reduced content in the blood albumin, protrombina, fibrinoguena, cholesterol. The increased content in the blood aminotransferaz, particularly alanine, it is commonplace to observe anaemia, the increase Monday. The degree of liver function can be determined by the radio gepatografii. In the third stage, there are profound metabolic disorders in the body, dystrophic phenomenon not only in the liver but also in other organs (central nervous system, kidneys, etc.); With chronic liver diseases was cachexia. There are signs of impending liver coma. Coma liver (gepatargia). The development of liver coma emit stage prekoma threatening coma, and of whom. There also pechenern-kletocnuu (endogenous) those resulting from the massive necrosis parenhima, portocavalnuu (obhodnuu, shuntovu, exogennouu) caused significant exception of the liver metabolism as a result of the expressed portocavalnah anastomosis, and mixed whom, existed mainly in zirrozah liver. In prekomatosny period is usually progressive anorexia, nausea, the erosion of the liver, jaundice increase, giperbilirubinemia, increase of biliary acids in the blood. Further increasing mentally Violations slow thinking, depression, and sometimes some euphoria. Volatility characteristic mood, irritability; Violated memory upset sleep. The EEG recorded slow delta-i tetavolna. Increasing sukhojile though, have minor tremor limbs. Developed azotemia. Under the influence of strong medication, patients may withdraw from this state, but more often with heavy irreversible changes occur liver coma. Between coma excitation, which is then replaced oppression (stalemate), and violation of progressive consciousness until the total loss of it. Promising meningeale phenomenon pathological reflexes, dwigatelnoe concern convulsions. Individual breath (type Kussmaula, Cheina-stocksa); Puls-maly, aritmichny; There is a body hypothermia. The patient osunuvsheesa, cold limbs, mouth, as well as the skin is characteristic sweetish smell liver increases of hemorrhagic (bleeding skin, bleeding from the nose, gums, varikoznorasshirennah veins oesophagus, etc.). Effective Monday, the level of residual nitrogen and ammonia in the serum, there are gipokaliemia and often giponatriemia, metabolic acidosis. In the terminal phase of the curve uploshchaeta EEG. Classification. The characteristics of acute liver need objective criteria to these violations of various origins. There are a few modern classifications UPP. The objective, reflecting the different sides of the pathological process is the classification of E. I. Galperina et al. , (1978). 1. Primary syndromes. * cholestasis syndrome : primary or secondary. * syndrome печеночно-клеточной deficiency : печеночноклеточная jaundice, violations белковосинтетической functions диатез bloody. * Subtotalnaya liver failure. 2. Secondary syndromes. * portal hypertension. * Violations of hemodynamics and homeostasis. 3. Acute and chronic liver failure (by the nature of the clinical course). 4. Complications liver failure. * kidney damage. * The defeat pancreas. * brain damage.

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