Alcoholic liver disease complications of treatment

1, upper gastrointestinal bleeding : chronic alcoholics with upper gastrointestinal bleeding, perhaps because of acute gastric erosion, canker or esophageal variceal bleeding (EVB), it must treat the bleeding site and treatment decisions. Ice water plus a small amount of norepinephrine or other hemostatic agents gastric lavage, the erosion caused by gastric bleeding may be effective. As for portal hypertension caused portal hypertensive gastropathy bleeding, can be used in determining good, he Shi Ning effective. Sandostatin set usage : 0.1mg slow intravenous infusion, followed by 3 mg intravenous drip, drip for at least 48 hours, bleeding ulcer disease can be treated with omeprazole or ranitidine. EVB treatment, now available three cavity Ballon oppression, increase in good will or sometimes he preferred treatment, usage Ibid. To better when hemostasis longer an option hardening agent therapy or varicose vein ligation therapy (EVL). AH (alcoholic hepatitis), caused by portal hypertension, treatment of portal pressure can return to normal, varicose veins can also disappear. 2, ascites : AH and AC (alcoholic cirrhosis) and ascites to improve liver function for the main treatment, when the portal pressure to normal, serum albumin levels increased, that is their own urine increased. Sodium intake should be restricted, the use of diuretics to be careful because AH, AC patients is often associated with hypokalemia, low magnesium, calcium, hypophosphatemia. Prohibited alone should be a major role in the proximal tubules of chlorine thiazide. Not because aldosterone antagonist distal tubules of the effect, it is not only right accompanied aldosteronism patients with cirrhosis of the lack of diuretic effect, Japan _ will intensify potassium, magnesium loss, induced hypokalemia alkalosis and hepatic coma, it should be combined, such as spironolactone (50-100mg) and the double hydrogen urine Cypriot grams (50-100 mg / d) combination. Treatment should pay attention to during the regular review of blood and urine electrolyte, ECG and blood gas analysis, to prevent hyperkalemia intense. 3, hepatic coma AC and the event AH patients with hepatic encephalopathy, should examine their attention induced causes, such as gastrointestinal bleeding, electrolyte and acid-base disorders, secondary infection, preventive use glutamate as sodium, potassium misconduct, such as excessive protein intake. Sometimes the reasons for its complexity. Gastrointestinal bleeding and infection control should be, electrolyte and acid-base disorders should be corrected promptly. Meanwhile advised to reduce intestinal bacteria type of amino acid and urea decomposition. 4, infections due AH, AC patients with poor nutritional status, low immunity and the ability to take care of themselves and poor sanitary conditions and other factors, the patient vulnerable to infection, especially lung infection and spontaneous bacterial peritonitis. The incidence of pneumonia than 3-4 times the population, and as one of the important causes of death, it should be in control of its importance. We should also be careful of spontaneous bacterial peritonitis in early diagnosis. In addition to conventional indicators, the current focus on ascites PH neutral and multinucleated cells (PMN) absolute count. The three were positive that the two may be considered with spontaneous bacterial peritonitis, and appropriate timely treatment. 5, electrolyte and acid-base balance disorders due to less intake, excretion, gastrointestinal and renal tubular absorption and acid-base disorders caused by alcohol, AC, AH patients, often seen electrolyte and acid-base disorders, and hypokalemia, low magnesium, calcium, hypophosphatemia and various acid-base balance. Its mechanism of ethanol metabolism and produce lactic acid and other metabolic complications, such as anemia, muscle pain, rhabdomyolysis, alcohol syndrome, hepatic coma and so on. Low potassium, low magnesium, calcium, phosphorus accompanied with the existence of clinical manifestations of Tourette, tremor, look difficult to distinguish between symptoms, ECG also lacks specific performance monitoring required blood and urine electrolyte. Ethanol metabolism produce lactic acidosis and ketosis, which can lead AG (anion gap), metabolic acidosis, ethanol excessive anesthesia can inhibit breathing respiratory acidosis, respiratory excessive alcohol syndrome can be induced respiratory alkalosis, severe vomiting induced by chlorine can, hypokalemic metabolic alkalosis. the latter easily induced hepatic encephalopathy. Serious infections such as mergers and improper medical treatment, the more complicated, and we need to monitor electrolytes, blood gas analysis, ECG and check whether the proper treatment, combined with the clinical treatment of timely adjustments.