最近审阅: 26 十月 2020
最近更新: 09 十月 2019

小结

定义

病史和体格检查

关键诊断因素

  • 存在的危险因素
  • 老年
  • 肝肿大

其他诊断因素

  • 腹胀
  • 食管或胃静脉曲张出血
  • 右上象限
  • 早饱感
  • 体重减轻
  • 下肢水肿
  • 肝性脑病
  • 恶病质
  • 黄疸
  • 脾肿大
  • 扑翼样震颤
  • 蜘蛛痣
  • 肝掌
  • 脐周侧支静脉
  • 肝臭
  • 腹泻
  • 癌旁综合征
  • 骨痛
  • 严重的腹痛
  • 梗阻性黄疸
  • 直肠静脉扩张
  • 血管杂音

危险因素

  • 肝硬化
  • 慢性乙型肝炎感染
  • 慢性丙型肝炎肝硬化
  • 慢性酗酒
  • 糖尿病
  • 肥胖
  • 肝癌家族史
  • 黄曲霉毒素
  • 钍造影剂
  • 血色病
  • 吸烟
  • α-1 抗胰蛋白酶缺乏
  • 迟发性皮肤卟啉症
  • 原发性胆汁性胆管炎 (Primary biliary cholangitis, PBC)
  • 原发性硬化性胆管炎
  • 雄激素类固醇
  • 口服避孕药
  • 男性

诊断性检查

首要检查

  • 全血细胞计数
  • 基础代谢检查
  • 肝功能检查
  • 凝血酶原时间/国际标准化比值
  • 病毒性肝炎指标
  • 甲胎蛋白 (AFP)
  • 肝脏超声
更多 首要检查

需考虑的检查

  • 腹部增强 CT
  • 腹部增强 MRI
  • 肝脏活检
  • 胸部计算机体层成像扫描
  • 骨扫描
更多 需考虑的检查

治疗流程

撰稿人

Senior Consultant, Gastroenterology & Hepatology

Assistant Professor, Yong Loo Lin School of Medicine

National University of Singapore

Singapore

利益声明

PST has received sponsorship/honorarium from Bayer (South East Asia) Pte Ltd and Sirtex for attending conferences, delivering lectures, and participating in advisory board meetings.

Associate Consultant

Department of Medicine

Division of Gastroenterology & Hepatology

National University Health System

Singapore 

利益声明

QDN declares that he has no competing interests.

Dr Poh Seng Tan and Dr Qingyao Daniel Huang would like to gratefully acknowledge Dr Badar Muneer and Dr Smruti R. Mohanty, previous contributors to this topic.

利益声明

BM declares that he has no competing interests. SRM serves as a speaker for Bristol-Myers Squibb regarding the use of entecavir for the treatment of chronic hepatitis B.

同行评议者展开全部内容

Gastroenterologist

Dartmouth-Hitchcock Nashua

Nashua

NH

利益声明

SN declares that he has no competing interests.

Professor of Medicine

Chief of Clinical Gastroenterology and Hepatology

University of Texas Medical Branch

Galveston

TX

利益声明

NS declares that he has no competing interests.

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