《陶小红cirrh》PPT课件

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1、CIRRHOSISofLIVERXiaohongTaoTheFirstAffiliatedHospitalChongqingUniversityofMedicalSciencesIntroduction一种或几种病因长期或反复作用引起的慢性进行性肝病的后期阶段。(It’stheendresultofhepatocellularinjuryresultedfromdifferentcauses,ERLD)病理—有广泛肝细胞变性坏死、肝细胞结节性再生、结缔组织增生及纤维化，正常肝小叶结构破坏和假小叶形成、肝逐渐变形、变硬。Thehistologicfeatureisdegenerati

2、on,regeneration(nodular)andfibrosis.Accordingtothefollowingsequence:INJURYDEGENERATIONandnecrosisregenerationFIBROSISFORMATIONOFFIBRO-VASCULARMEMBRANESPARENCHYMALDISSECTIONINTONODULESREARRANGEMENTOFBLOODCIRCULATIONCIRRHOSISREARRANGEMENTOFBLOODCIRCULATIONCIRRHOSISIntroduction临床—肝功能损害和门脉高压为

3、主、晚期常出现消化道出血、肝性脑病等并发症。(Theclinicalmanifestationscanbebroadlyclassifiedintothoseresultingfromhepatocellulardysfunction,suchasjaundiceandcoagulopathyandportalhypertension.Thecomplicationoftenappearinlatephase,suchashemmorrage,hepaticencephalopathy.世界性疾病，所有种族、不论国籍、年龄或性别、均可罹患。年龄35～48岁最多，男：女为3．6～8

4、：1。Cirrhosisisthethirdmostcommoncauseofdeath,afterheartdiseaseandcancer.killingabout25,000peopleeachyear.IntroductionHISTORYIn1761,Thispeculiartransformationoftheliverwasidentifiedbythefirstanatomicpathologist,GianbattistaMorgagniinhis500autopsies.HISTORYIn1826(65yearslatter),thenameofcirrhosi

5、swasgivenbyLaennecbecauseoftheyellowish-tancolorofthecirrhoticliver."cirrhosis"(greek=orangecolor).HISTORYOnlyin1930,onehundredyearslater,thefirsttheoryastothepathogenesisofthisdisorderwasadvancedbyRoessle:parenchymaldegeneration,regenerationandscarringwhichisnowunderstoodaccordingtothefollowi

6、ngsequence:HISTORYINJURYDEGENERATIONFIBROSISFORMATIONOFFIBRO-VASCULARMEMBRANESPARENCHYMALDISSECTIONINTONODULESREARRANGEMENTOFBLOODCIRCULATIONCIRRHOSISREARRANGEMENTOFBLOODCIRCULATIONCIRRHOSIS其他病因寄生虫感染血吸虫、华枝睾吸虫胆汁淤积肝内淤胆或肝外胆管梗阻循环障碍慢性充血性心力衰竭、缩窄性心包炎肝静脉和（或）下腔静脉梗阻工业毒物四氰化碳、磷、砷、双醋酚丁、四环素代谢障碍血色病（铁质沉积）、肝

7、豆状核变性（铜沉积）营养障碍慢性炎症性肠病、食物中缺乏蛋白质、维生素、抗脂肝物质原因不明病因ETIOLOGY(CAUSES)ETIOLOGY2.Alcoholabuse143.Bileductobstruction(PBC,PSC)4.ExposuretocertainchemicalsUseofcertaindrugs(CCI4)135.Persistentobstructiontooutflowofbloodfromtheliver(suchasoccursint