Liver dysfunction includes acute and chronic liver diseasesliver functionAbnormalities, such as liver cirrhosis, liver failure and liver cancer patients, also include critically ill patients, severe infectionsoperationLiver dysfunction secondary to trauma.Cirrhosis is the formation of liver fibrosis and regenerative nodules on the basis of chronic liver injury, which will eventually lead to liver failure and portal hypertension, and progress to the end of the disease.Liver failure: chronic liver failure and chronic liver failure. Chronic liver failure is an acute liver failure based on chronic liver disease, and chronic liver failure is a manifestation of end-stage cirrhosis.
The liver is one of the important organs of the human body. Many important substances of the human body are metabolized in the liver, such as the digestion, absorption and storage of nutrients;Synthesis of coagulation factors;Detoxification and excretion of metabolites;Enzyme regulation;The maintenance of water and electrolyte balance in the body;Hormone metabolism;Bile production, metabolism and immune function.
differential diagnosis
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It mainly includes the following contents: ① protein function test, such as determination of total serum protein and albumin globulin ratio, serum protein electrophoresis, serum colloid stability test, plasma coagulation factor test, blood ammonia determination, etc. ②Glucose metabolism function test, such as glucose tolerance test, dehydrocortin glucose tolerance test, galactose tolerance test. ③Fat metabolism function test, such as serum cholesterol determination, serum cholesterol ester determination, etc. ④Bilirubin metabolic function test, such as quantitative test of serum total bilirubin and direct bilirubin, qualitative test of urinary bilirubin and bilirubin. ⑤Liver dye excretion function test, such as sodium bromosulfonate retention test, indigo green retention test, etc. ⑥Clinical enzymology examination, such as serum transaminase assay, serum alkaline phosphatase assay, serum γ - glutamyltransferase assay, serum monoamine oxidase assay, serum 5 '- nucleotidase assay, serum leucine aminopeptidase assay, etc.
inspect
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Through the metabolic function test of protein, sugar, fat and bilirubin and clinical enzymology examination, the laboratory can understand whether various liver functions are damaged and the degree of damage, judge the prognosis, screen drugs and observe the efficacy, conduct health examination and evaluate the patient's tolerance before operation.The commonly used indicators are the determination of serum total protein and A/G ratio;Determination of TTT, GPT and serum bilirubin.
Therapeutic principles
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A large number of research data show that the survival rate of liver cirrhosis patients with protein energy malnutrition is reduced.Protein energy malnutrition is accompanied by a decrease in skeletal muscle and serum albumin levels. These indicators are prognostic indicators to judge the reduced survival rate of patients with cirrhosis.Nutrition management can improve protein energy malnutrition and muscle loss in patients with liver dysfunction.Nutrition management includes adequate dietary intake, correct eating time and improvement of nutritional metabolism.BCAA is an ideal nutritional supplement for patients with liver dysfunction.It is necessary to add meals before bed to correct hunger in the morning and reduce protein and fat decomposition in the body.Nowadays, most studies believe that carbohydrate or a mixture of carbohydrate and branched chain amino acid is the best material for adding meals before sleep.The improvement of nutritional status of liver cirrhosis patients requires the joint efforts of multidisciplinary nutrition support teams.Proper exercise management combined with nutrition supplement may be an important method for the management of patients with liver dysfunction.
