Complications of alcoholic liver disease treatment

1, upper gastrointestinal bleeding: persons with chronic alcohol upper gastrointestinal bleeding, perhaps because of acute gastric erosion, canker or esophageal variceal bleeding (EVB), is subject to the bleeding site of the treatment decision. Ice water and a small amount of norepinephrine or other bleeding gastric lavage of the erosion caused by gastric bleeding may be effective. As for portal hypertension caused portal hypertensive gastropathy bleeding can be a good set, he Shi Ning effective. Sandostatin in the usage: 0.1 mg slow intravenous injection, then 3 mg intravenous continuous infusion for at least 48 hours, bleeding ulcer disease or ranitidine available treatment Losec. EVB treatment, the balloon is now available three cavity of oppression, plus a good set or he Shi Ning treatment, and applying Ibid. To better when hemostasis longer an option hardening agent therapy or ligation varicose vein therapy (EVL). AH (alcoholic hepatitis) portal hypertension caused by the 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 as the main treatment, when the portal pressure to normal, serum albumin levels increased, that is, to increase urine output. Sodium intake should be restricted, the use of diuretics is necessary to be careful because AH, AC patients often associated with hypokalemia, low magnesium, low calcium, hypophosphatemia. Should be banned single major role in proximal tubular chlorine Thiazide. Not because of the distal tubular aldosterone antagonist role, it not only with aldosteronism on the lack of diuretic effect in patients with liver cirrhosis, Japan _ will aggravate potassium, magnesium loss, evoked hypokalemic alkalosis and hepatic coma, it should be combined, such as spironolactone (50-100 mg) and the double urine Cypriot grams of hydrogen (50-100 mg / d) combined. Treatment should pay attention to during the regular reexamination blood and urine electrolyte, ECG and blood gas analysis to prevent the occurrence of high-K school. 3, hepatic coma patients such as AC and AH in hepatic encephalopathy should be induced to examine their reasons, such as gastrointestinal bleeding, electrolyte and acid-base disorders, secondary infection, preventive use glutamate as sodium, potassium misconduct, such as excessive protein intake. Its causes are sometimes complicated. Gastrointestinal bleeding and infection should be controlled, electrolyte and acid-base disorders should be promptly corrected. At the same time advised to reduce intestinal bacterial type of amino acid and urea decomposition. 4, infections due AH, AC patients with poor nutritional status, low immunity, as well as activities of daily living and health conditions affected by factors such as poor, vulnerable patients infected, especially lung infection and spontaneous bacterial peritonitis. The incidence of pneumonia in 3-4 times higher than that of the crowd, and an important cause of death for one, it should be in control of their attention. At the same time spontaneous bacterial peritonitis attention to the early diagnosis. In addition to conventional indicators, the current emphasis on ascites PH multinucleated cells and neutrophils (PMN) absolute count. Two of the three should consider the possible positive 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 due to bad acid-base disorders, as well as ethanol, AC, AH patients, electrolyte and acid-base often arise disorder, with hypokalemia, low magnesium, low calcium, hypophosphatemia and various acid-base balance. Its produce ethanol metabolism and the mechanism of lactic acid and other metabolic produce complications, such as anemia, muscle-ache, rhabdomyolysis, alcohol syndrome, hepatic coma, and so on. Low potassium, low magnesium, low calcium, phosphorus accompanied with the existence of clinical manifestations spasm, tremor, look difficult to distinguish the symptoms, ECG there is a lack of specific performance monitoring required blood and urine electrolyte. Metabolism produce ethanol, lactic acidosis, ketosis can lead AG (anion gap) metabolic acidosis, respiratory inhibition of ethanol excessive anesthesia can cause respiratory acidosis, excessive alcohol syndrome can be caused by breathing respiratory alkalosis, can be severe vomiting induced by low chlorine, hypokalemic metabolic alkalosis, latter-induced hepatic encephalopathy. If the merger of serious infections and improper medical treatment, the more complicated, you need to attach importance to monitoring electrolytes, blood gas analysis, ECG and check whether the proper treatment, combined with clinical timely adjust treatment.