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目的探讨酒精性肝硬化的临床特点及诊治方法。方法以同期住院的乙型肝炎后肝硬化为对照,对68例酒精性肝硬化患者临床资料进行回顾性分析。结果酒精性肝硬化占同期住院肝硬化总数的8.5%,发病年龄平均(53.5±14.6)岁;日平均饮酒折合乙醇量>135 g,持续10年以上;酒精性肝硬化中面色黝黑、肝掌、蜘蛛痣、肝大、男性乳房发育、腮腺肿大等体征明显且多见,γ-谷氨酰基转移酶(GGT)、AST异常及肝原性糖尿病、消化性溃疡、高尿酸血症、高脂血症较常见,可出现戒酒综合征、痛风、痛风性关节炎和股骨头坏死等并发症;临床好转53例(77.9%),无效9例(13.2%),死亡6例(8.8%)。结论面色黝黑、肝掌、蜘蛛痣、肝大、男性乳房发育、腮腺肿大等体征、并发症的发生情况及血液生化检查结果,有助于酒精性肝硬化的临床诊断和鉴别诊断;戒酒不能阻止酒精性肝硬化病情进展;长期针对内毒素血症的治疗,有可能改善酒精性肝硬化的预后。
Objective To investigate the clinical features and diagnosis and treatment of alcoholic cirrhosis. Methods The data of 68 patients with alcoholic cirrhosis were retrospectively analyzed in the same period of hospitalized hepatitis B cirrhosis. Results Alcoholic cirrhosis accounted for 8.5% of the total number of hospitalized cirrhosis in the same period, with an average age of onset of (53.5 ± 14.6) years; average daily alcohol consumption equivalent to 135 g for more than 10 years; alcoholic cirrhosis with dark complexion, , Spider nevus, hepatomegaly, male breast development, parotid gland enlargement and other signs were obvious and more, γ-glutamyl transferase (GGT), AST abnormalities and hepatic diabetes, peptic ulcer, hyperuricemia, high Lipids were more common, there may be alcohol withdrawal syndrome, gout, gouty arthritis and femoral head necrosis and other complications; clinical improvement in 53 cases (77.9%), ineffective in 9 cases (13.2%), death in 6 cases ). Conclusion The appearance of dark complexion, hepatomegaly, spider nevus, liver enlargement, male breast development, parotid gland enlargement and other complications and blood biochemical test results are helpful for the clinical diagnosis and differential diagnosis of alcoholic cirrhosis. Can not stop the progression of alcoholic cirrhosis; long-term treatment of endotoxemia may improve the prognosis of alcoholic cirrhosis.