Chapter 17 Hepatic failure 一一一--二二-一二-一-一一-一
1 Chapter 17． Hepatic Failure
Section 1 Concept of hepatic failure 一一一--二二-一二-一-一一-一 2
2 Section 1. Concept of hepatic failure
1. Definition of hepatic failure →--1--1-÷----1-1------4 Various harmful factors parenchymal cells and Kupffer cells damadged severely and extensively severe disturbance of liver function in metabolism, secretion, synthesis, detoxication and immunity jaundice, bleeding, infection, renal dysfunction and encephalopathy Hepatic insufficiency (late stage)Hepatic failure hepatorenal syndrome and hepatic encephalopathy
3 1. Definition of hepatic failure Various harmful factors ↓ parenchymal cells and Kupffer cells damadged severely and extensively ↓ severe disturbance of liver function in metabolism, secretion, synthesis, detoxication and immunity ↓ jaundice, bleeding, infection, renal dysfunction and encephalopathy ↓ “Hepatic insufficiency” ↓ (late stage) “Hepatic failure” hepatorenal syndrome and hepatic encephalopathy
2. Classification and causes Severe, extensive degeneration and necrosis of hepatic cells Acute(fulminant) hepatic failure Late stage of cirrhosis or carcinoma of the liver Chronic hepatic failure
4 Severe, extensive degeneration and necrosis of hepatic cells → Acute (fulminant) hepatic failure Late stage of cirrhosis or carcinoma of the liver → Chronic hepatic failure 2. Classification and causes
3. Effects of hepatic failure on the body (1) Disturbance of metabolism carbohydrate protein electrolyte (2)Obstacle of bile secrete and excrete hyperbilirubinemia, intrahepatic cholestasis (3)Disorder of coagulation generation or consumption clotting factor→>bd ng tendency (4)Dysfunction of bioconversion drug metabolism; detoxication of toxin, inactivation of hormone (5)Dysfunction of immune(Kuppfer cells bacterial infection, bacteremia, intestinal endotoxemia
5 (1) metabolism: (2) bile secrete and excrete: (3) coagulation: (4) bioconversion (5) immune Disturbance of metabolism: carbohydrate, protein, electrolyte Obstacle of bile secrete and excrete: hyperbilirubinemia, intrahepatic cholestasis Disorder of coagulation: generation↓ or consumption↑ → clotting factor↓→ bleeding tendency Dysfunction of bioconversion drug metabolism; detoxication of toxin; inactivation of hormone Dysfunction of immune (Kuppfer cells) bacterial infection, bacteremia, intestinal endotoxemia 3. Function of normal liver 3. Effects of hepatic failure on the body