消化系统七年制3肝脏疾病.pdf

肝脏疾病 1 Liver cirrhosis • 病因：肝炎、血吸虫、酒精中毒、营养不良、 慢性胆道梗阻 • 肝功能损害和门静脉高压 • 早期无症状，晚期可有腹水、脾肿大、食管静 脉曲张、上消化道大出血、黄疸、肝昏迷等 • 病理生理基础：门脉性、坏死性、胆汁性 2 肝硬化(cirrhosis) • 肝硬化早期可无影像学改变 • CT与MRI – 体积改变 – 轮廓改变 – 肝门、肝裂增宽 – 左右叶比例失调 – 脾增大 （大于5个肋单元） – 门脉高压征象 – 腹水 3 cirrhosis • The patient with cirrhosis in early stage may hav e no any changes on CT and MR. – T h e l iv e r b e c o m e s h ep at o m e g aly i n e a rly st a g e a n d hepatatrophy in late stage. – The contour of the liver may be wave-like . – The ratio of the right to the left lob is abnormal – The portal hepatis’ or/and liver fissura’s spaces become wide – Splenomegaly (always exceeds five rib units) 4 5 肝硬化、门-脐静脉分流、肝癌 6 血吸虫肝硬化 7 8 肝脓肿 (liver abscess) • Clinic and pathology – Liver abscess may be bacterial or amoebic abscess. – May be solitary or multiple lesions. – The clinical symptoms include fever, hepatomegaly or/and hepatic region pain. – WBC ↑ • 临床与病理： – 细菌性肝脓肿、阿米巴脓肿 – 单发或多发 – 临床症状主要为发热、肝肿大和肝区疼痛 – 白细胞计数增加 9 影像学表现 •