Severe liver failure, symptoms, treatment. Liver failure. Causes, symptoms, signs, diagnosis and treatment of pathology

Damage to the liver tissue leads to dysfunction of this organ. One of the most serious complications is liver failure, in which the risk of death is high. What are the provoking factors of this disease, as well as what to do to prevent such conditions, our article will tell you.

Classification

The pathogenesis of the disease is a violation of the detoxification function of the liver, as a result of which toxic substances accumulate in the body. ammonia, phenols, fatty acid and other metabolic products cause CNS damage.

classify the following forms liver failure:

• Hepatocellular insufficiency occurs when the liver cells are massively damaged by toxic substances. These are mainly poisonous mushrooms, low-quality alcohol, harmful chemical compounds. The disease has an acute and chronic form, in which the process of cell death proceeds at different rates.
• The portocaval form is diagnosed with problems with high blood pressure in the portal vein. It is responsible for transporting blood to the liver, and also nourishes the cells of the organ. Auxiliary veins that provide continuous work, under the influence of increased blood pressure, are prone to rupture and deformation, which leads to internal bleeding. This form of the disease is usually chronic. General intoxication of the body occurs due to the fact that the blood does not undergo sufficient purification and enters the bloodstream along with toxins and decay products.
• The mixed form is the most common, and symptoms include lesions at the cellular level, as well as dysfunction in blood purification and malnutrition of the organ.

The disease can be chronic and acute form. In the first case, the pathology develops very slowly, over several years. Acute forms of liver failure occur much faster. If the necessary measures are not taken, the person may die.

Such a rapid development of liver lesions is also called fulminant. Most often this is caused by viral forms of hepatitis, as well as toxic poisoning.

stages

Despite the fact that the liver may not supply for years alarms, diseases of this organ are extremely severe and require special attention.

The following forms of damage are distinguished:

1. Initial (compensated).
2. Expressed (decompensated).
3. Terminal dystrophic.

IN last case the chances of recovery are very small, because the body completely stops its work.

Causes

Most often, serious liver damage occurs due to viral diseases, as well as toxic poisoning.

The precipitating factors include abuse and drugs, overuse protein food, as well as internal bleeding of various pathogenesis.

Liver failure may result from electrolyte balance, as well as against the background of exacerbation of chronic diseases of internal organs.

Symptoms

The nature of the manifestation of the disease is often the same in different forms and stages. There are two types pathological processes: cholestasis syndrome and liver tissue necrosis.

The first type of violation is manifested mainly by blockage of the bile ducts, which leads to the appearance of jaundice. This is the most feature problems with the liver, which is easily determined by staining the surface of the skin and changing the sclera of the eye.

In this case, jaundice can be subtle, only concomitant symptoms and laboratory tests can accurately determine the patient's condition.

On the part of the pulmonary system, there may be respiratory disorders, and other alarming symptoms associated with the ingestion of blood clots into the organs.

Violations also affect the activity of the nervous system. The patient has a dullness of consciousness, hyperexcitability is replaced by apathy, there is a feeling of anxiety and even uncontrolled attacks of aggression.

acute form

The disease manifests itself no later than a month after toxic exposure, but most often alarming symptoms can be noticed within a few hours.

These include:

• Nausea and vomiting.
• Digestive disorders.
• yellowing of the sclera and skin.
• Pain in the right hypochondrium.
• Tremor of the limbs.
• Bad breath.
• Disorders of consciousness.
• Feverish conditions.

From timely emergency care depends on the prognosis. Usually this form of the disease

Chronic liver failure

This disease develops over the years, the main causes are malnutrition, alcohol abuse, drugs and "harmful" food. Provoking factors include the unfavorable region of residence, as well as working conditions.

Symptoms chronic form liver failure are also signs of acute toxic liver damage, but the prognosis for treatment in this case will be more unfavorable.

How does the disease manifest itself in children?

Despite the fact that this disease is diagnosed mainly in adulthood, liver failure also poses a certain threat to children.

signs possible pathologies and congenital liver defects appear as early as the second week of life. Do not confuse them with the so-called "jaundice of the newborn."

Puffiness is often observed with liver dysfunction abdominal cavity(), hematomas on the skin and hyperventilation of the lungs. Complications given state sometimes encephalopathy and coma.

There are cases when the cause of such a disease is not in birth defects, and in case of food poisoning, in particular wild mushrooms.

In addition, uncontrolled use of paracetamol-based antipyretics can lead to such problems. In this case, the prognosis is more favorable, especially if health care was given at the first sign of symptoms.

Diagnostics

If the above symptoms are detected, the diagnosis is made according to the results of biochemical blood parameters, EEG, hepatoscintigraphy.

What indicators you need to pay attention to:

• Hemoglobin in any liver disease becomes below normal. When kidney failure it falls below the 90 mark.
• Leukocytes and ESR increases, but this can be a signal of many inflammatory processes in organism.
• The level of platelets decreases due to hemorrhagic syndrome.
• Bilirubin increases significantly. In acute liver failure, about 50 - 100 times the norm.
• Special indicators of liver tests - ALT and AST. Exceeding the norm indicates necrosis of liver cells.
• Thymol test - analysis of the ratio of protein components of the blood. At elevated level speaks of liver dysfunction.
• Glucose, urea, total protein, globulins and albumins - these indicators will be below normal.
• Cholesterol, iron, alkaline phosphatase and ammonia - the presence of these components will be many times higher.

In addition, markers of viral hepatitis are carried out. IN normal condition they cannot be detected in the blood.

Instrumental diagnostics for suspected liver failure is carried out using the abdominal organs, EEG (electroencephalography), and.

In special cases, a puncture is performed, in which tissue samples of the organ are taken for further research.

Complications

Liver failure is itself a life-threatening condition. Further damage to the liver tissues can lead to the entry of toxins into the brain, as a result of which it develops.

Irreversible processes affecting the central nervous system lead to the development of hepatic coma. This is the most severe consequences liver failure, the chances of survival for which are negligible.

Treatment

The main tactic of therapy for such conditions is life support. important indicators and elimination of the cause of the disease. Treatment is necessarily carried out in stationary conditions, in severe cases - in intensive care.

Important stages of treatment:

1. Stop internal bleeding. These include operations to restore blood vessels, taking hemostatic drugs, as well as infusion of donor blood and its derivatives (plasma, platelets)
2. Removal of intoxication of the body. This is a thorough cleaning of the intestines, taking drugs that regulate its function, as well as detoxification agents.
3. Restoration of energy reserves and normal volume of blood supply. For this, they are used intravenous administration saline solutions, glucose and albumin.
4. Improvement of blood supply to the liver. For this, they are used special preparations, as well as apparatus artificial ventilation lungs if you have trouble breathing.
5. Restoration of liver function. Drug treatment consists in taking such drugs as: Arginine, Hepa-Merz, Ornithine, as well as hepatoprotectors and complex vitamins.
6. Used to correct the functioning of the brain sedatives and diuretics, as well as drugs that improve cerebral circulation.

Be sure to follow a low-protein diet, as well as extracorporeal methods. These include hemodialysis, where the blood is cleansed of toxins through an "artificial kidney" device. Another one effective procedure- plasmophoresis, which cleans the blood plasma from metabolic products and toxins.

In severe conditions of the organ, liver transplantation is necessary, but this method has a high degree of risk and is not always effective.

Forecast and prevention

Timely treatment, as well as further rehabilitation measures, increase the chances of recovery.

Liver failure is a serious disease, the prognosis for which is very unfavorable. In most cases, full recovery does not occur, the patient must adhere to strict restrictions for the rest of his life, as well as periodically undergo maintenance therapy.

The survival rate for acute liver failure is approximately 50-70%, but in severe cases, when the disease has progressed to the stage of hepatic encephalopathy or coma, the chances of survival are only 1-3%.

Prevention methods include:

• Healthy lifestyle.
• Regular preventive examinations.
• Maintain normal weight.
• Avoidance of alcohol and drugs.
• Prohibition on eating wild mushrooms.
• Compliance sanitary norms At work.

Damage to liver cells by toxins or viruses, as well as supply disruptions nutrients may lead to renal failure. This is an extremely serious condition that poses a threat to the life of the patient. what stages are distinguished, symptoms, as well as the main methods of treating this disease - all these questions will be answered by the information provided.

Video about liver failure in oncology:

Liver failure - medical term denoting a complex of symptoms that develop as a result of the destruction of the liver parenchyma and a violation of its basic functions. This pathological condition manifested by intoxication of the body, since the liver ceases to perform a detoxifying function and harmful substances accumulate in high concentrations in the blood and tissues.

Violation of one or more liver functions leads to metabolic disorders, malfunctions of the nervous system and brain. severe forms liver failure provoke irreversible processes that can result in the development of hepatic coma and death.

Purpose of the liver

The liver is an unpaired organ, the largest and most important endocrine gland, located in the region of the right hypochondrium. In our body, this organ performs more than 500 important functions. We list the main ones:

• bile is produced in the liver, which is necessary for the breakdown and further absorption of lipids (fats) that enter the body with food;
• this body is directly involved in protein, fat and carbohydrate metabolism;
• utilizes the breakdown products of hemoglobin, turning them into bile acids and removing from the body with bile;
• neutralizes toxins, allergens and other harmful and toxic substances, accelerates their elimination from the body in a natural way;
• deposits stores of glycogen, vitamins and microelements;
• synthesizes bilirubin, cholesterol, lipids and other substances involved in the process of digestion;
• provides splitting and utilization of excess hormones, enzymes and other biologically active substances.

The liver is the main filter of our body.

This organ is subjected to high daily loads, which we further increase if we violate the diet, eat fatty, spicy, fried foods, overeat, abuse alcohol, or randomly take drugs with a hepatotoxic effect.

At the same time, the liver is the only organ capable of self-healing. Its cells (hepatocytes) are able to regenerate due to the growth and increase in their number, and even with extensive damage (up to 70%), the liver can fully recover to its previous volume if the causes that provoke the destruction of the parenchyma are eliminated.

The rate of liver regeneration is rather slow and largely depends on the age and individual characteristics of the patient, as well as on the severity of the underlying disease that causes the destruction of hepatocytes. You can speed up the recovery of the organ if you lead a healthy lifestyle and adhere to proper nutrition, that is, reduce the load on the liver. At the same time, you should know that liver regeneration is impossible if its destruction is caused by active infectious process(for example, with viral hepatitis).

Types and forms of liver failure

Depending on the nature of the course of the disease, acute and chronic liver failure are distinguished.

Acute liver failure is manifested against the background of toxic lesions of the organ (alcoholic, drug, viral hepatitis).

The chronic form of the disease develops gradually, along with the progression of hepatic pathologies (fibrosis, tumor processes).

The pathogenesis of liver failure or the mechanism of the development of the disease implies its division into several types:

• Hepatic cell failure - develops when the cells of the body are damaged by toxic substances (poisons, viruses, alcoholic surrogates). In this case, the disease can proceed in an acute form, accompanied by massive death of hepatocytes, or in a chronic form, when cells die slowly and the severity of symptoms increases gradually.
• Porto-caval form - associated with impaired hepatic blood flow. As a result, blood saturated with toxic substances bypasses the liver and from the portal vein enters immediately into the general circulation. In addition, with this form of insufficiency, liver cells suffer from hypoxia. Such disorders occur due to cirrhosis or during bypass surgery for portal hypertension.
• mixed form. In this case, chronic liver failure is diagnosed, accompanied by the death of liver cells and the discharge of blood saturated with toxins into the general circulation.

Depending on the stage of development, liver failure is divided into the following types:

• compensated (initial stage);
• decompensated (pronounced form);
• terminal (dystrophic);
• hepatic coma.

At the initial, compensated stage, there are no symptoms of the disease, the life expectancy of patients is about 20 years.

In the stage of decompensation proceeds with bright severe symptoms and occasional relapses.

At the terminal (dystrophic) stage, the patient requires permanent care and medical supervision, and the disease is steadily progressing.

Causes of liver failure

In addition, factors such as: acute disorder circulation in the liver oncological tumors, including cancer metastases from other organs to the liver, fatty liver of pregnancy, or abdominal surgery, in which the hepatic artery is accidentally damaged.

Symptoms of liver failure

At the initial stage of the disease, signs of liver failure are similar to many pathologies associated with dysfunction of internal organs. Therefore, the syndrome of renal failure is so difficult to diagnose in time. A person usually does not attach much importance to the lack of appetite, weakness, fatigue, attributing the malaise to the accumulated fatigue. But as the disease progresses, it manifests itself with intolerance to certain foods and alcohol, taste perversion, nausea, vomiting, digestive disorders, and dysfunction of the nervous system.

In the chronic course of the disease, the complexion becomes earthy, there is yellowness of the skin, signs of beriberi, endocrine disorders, disorders menstrual cycle in women and impotence in men. The manifestations of liver failure are diverse, they largely depend on the form of the disease, the characteristics of the course of the disease and are expressed as follows.

Features of the course of the disease

1. cholestasis syndrome. It is associated with a violation of the outflow of bile from the liver and the accumulation in the blood of the breakdown product of hemoglobin - bilirubin. This substance exhibits toxic effect and becomes the reason skin itching and yellowness of the skin and sclera. In addition, with cholestasis, lightening of feces and darkening of urine, which takes on the shade of dark beer, are observed. There are pulling aching pain in the right hypochondrium associated with obstruction of the biliary tract.
2. Dyspeptic disorders. Nausea and vomiting may occur intermittently after eating certain foods or be permanent. This is due to the fact that the liver does not synthesize enough bile, which is necessary for the full digestion of fats. Lack of appetite, up to a perversion of taste and desire to consume incompatible or inedible products (chalk, earth), are associated with intoxication of the body and damage to the nervous system against the background of liver necrosis. A specific hepatic odor from the mouth, reddening of the palms, and weight loss additionally indicate developing insufficiency.
3. Symptoms of intoxication of the body. Constant weakness, increased irritability, headache, joint and muscle pain, fever, fever, chills, profuse sweating at night - these manifestations are especially pronounced in acute renal failure. At the same time, the temperature can rise sharply to high values ​​​​or stay at 38 ° C for a long time, which, together with strong weakness and malaise have an extremely negative impact on performance and general well-being person.
4. Hepatic encephalopathy It is manifested by a dysfunction of the nervous system, since toxic substances and decay products are not neutralized by the liver and, acting on the brain, cause a number of characteristic symptoms. Patients complain of dizziness, decreased concentration, lethargy, apathy, lethargy, confusion, daytime sleepiness and insomnia at night. As further development disease occurs increased anxiety, depressive states, excessive excitability, convulsions, loss of consciousness, hallucinations.
5. Symptoms of the heart and blood vessels. Jumps are noted blood pressure, changes heart rate(arrhythmias), circulatory disorders.
6. Pulmonary symptoms. On the part of the respiratory system, there is the appearance of cough, shortness of breath, rapid or difficult breathing against the background of an increase in pulmonary edema. Pi this patient is afraid to suffocate and takes a forced sitting position. Shortness of breath can increase not only during physical exertion, but also at rest.
7. portal hypertension syndrome expressed as ascites (an increase in the volume of the abdomen due to accumulating fluid) and the appearance of spider veins on the surface of the abdomen and shoulders. Another characteristic symptom is an increase in the size of the spleen and liver, which is easily determined by palpation of the abdomen.
8. muscle weakness(atrophy) develops against the background of a lack of glycogen - the main energy supplier for the muscles. Muscles become flabby, lethargic, a person gets tired quickly and hardly performs physical work.
9. Blood clotting disorder leads to gastrointestinal and nosebleeds. This may cause bloody vomiting or blood in the stool (melena). The development of bleeding contributes to the expansion of the veins of the esophagus, which, against the background of portal hypertension, lose their permeability and mobility.

Thus, with liver failure, absolutely all organs and systems suffer. human body. Therefore, it is so important to start treatment in a timely manner and prevent serious complications that threaten the life of the patient.

Diagnostic methods

When making a diagnosis, a number of laboratory and instrumental methods of examination are used. The patient must pass a series of tests:

• (general and biochemistry);
• urinalysis (general);
• analysis of feces for occult blood;
• blood test for viral hepatitis;
• liver tests.

Of the modern instrumental diagnostic methods, ultrasound, CT or MRI are used. These methods allow assessing the size of the liver, its structure, the degree of damage to the parenchyma and blood vessels, as well as the presence of concomitant diseases associated with dysfunction of the biliary system (the presence of stones in the gallbladder, compression of the bile ducts).

If necessary, a radioisotope scan of the liver is performed or a biopsy is taken (if a malignant process is suspected) and the biopsy is sent for histological examination.
Additional body methods are used to assess the state of other organs and systems, since the whole body suffers from manifestations of liver failure. To this end, the patient is referred for a consultation with a cardiologist, neurologist, gastroenterologist, endocrinologist and other narrow specialists.

Treatment

The treatment of liver failure is a complex and lengthy process that includes not only drug therapy, but also the adjustment of the entire lifestyle and diet. The patient is given a specific diet, with restriction of salt and protein, which he must adhere to until complete recovery. Therapeutic measures include detoxification of the body, the use of medications, the action of which is aimed at improving blood circulation, normalizing electrolyte processes, and achieving acid-base balance.

With the development of acute liver failure, intensive therapy in a hospital setting. To restore the volume of circulating blood, a saline solution or other saline solutions while controlling urine output.

At hemorrhagic syndrome Hemostatic agents are used to stop bleeding. With the ineffectiveness of their use, they resort to blood transfusion.

To reduce the symptoms of intoxication, drugs are administered, the action of which is aimed at enhancing intestinal motility and cleansing the body. In order to detoxify, an infusion of rheosorbilact or neogemadez is carried out.

In order to improve blood circulation in the liver and reduce edema, osmotic preparations (sorbitol) are administered, agents such as eufillin, thiotriazoline are used to expand the ducts, and cocarboxylase or cytochrome is prescribed to eliminate hypoxia. At the same time, with the help of glucose and albumin, they replenish the energy reserves of the body. To speed up the processes of regeneration and restoration of liver cells, the following drugs are used:

• hepatoprotectors (Essentiale, Essliver Forte, Liv-52);
• Arginine, Hepa-Merz (these funds help the formation of urea from ammonia);
• amino acids, vitamins of group B, PP.

To maintain the functioning of the brain, drugs are used to improve cerebral circulation (Actovegin, Cerebrolysin), diuretics (Mannitol, Lasix), as well as sedatives.

In chronic liver failure, the pathologies that led to damage to the liver cells should be treated first. In addition to taking the main medications, it is necessary to adjust the metabolism based on the data biochemical research blood, as well as follow a certain diet. To the list of main medicines in the treatment of chronic forms of liver failure include:

• antibiotics a wide range actions that do not have a toxic effect on the liver (Neocin);
• amino acids (glutamic acid), which bind ammonia and remove it from the body;
• lactulose preparations (Dufalak, Portalak), which inhibit pathogenic microflora and eliminate ammonia intoxication;
• potassium preparations, vitamins C, PP, group B - compensate for the lack of potassium, improve the condition of blood vessels, activate the processes of regeneration of liver cells, and exhibit antioxidant properties;
• hepatoprotectors (Heptral, Essentiale Forte) - contain amino acids and phospholipids, which are the building material for liver cells.

If necessary, the body is detoxified with infusion solutions (glucose, sodium chloride solution or Ringer's solution). With stagnation of bile prescribed choleretic agents(Allochol, Holosas), for pain in the right hypochondrium, antispasmodics (No-shpu, Drotavein) or Baralgin are used.

In severe cases, at the stage of hepatic coma, hemodialysis and plasmapheresis procedures are necessary to clean and filter the blood from toxic substances.

Diet and nutritional habits

In the treatment of liver failure, special attention is paid to proper nutrition. Principles diet food with this pathology are as follows:

• protein products are completely excluded from the diet or reduced to a minimum;
• the emphasis is on fractional nutrition - you need to eat a little, but often (5-6 times a day);
• in the diet it is necessary to increase the amount of fiber and eat more fresh fruits and vegetables;
• the diet should include a small amount of easily digestible carbohydrates (honey, sweet fruits and berries), as well as foods high in beneficial vitamins and microelements;
• the daily calorie content of the diet is at least 1500 kcal, while tasty meals should be prepared, since many patients have a lack of appetite.

After the condition improves, they gradually return to the previous diet and introduce vegetable proteins into the menu first, then dairy products. With good tolerance of such a diet, dietary meat is included in the patient's diet.

It is necessary to maintain water balance, increase fluid intake, avoid heavy physical activity, normalize psychological condition, adjust correct mode work, rest and sleep.

The intake of any drinks should be completely abandoned, as well as unsystematic use. medicines. You can take only those medicines that have been prescribed by your doctor. As the condition improves, it is recommended to move more and take long walks in the fresh air.

- an acute or chronic syndrome that develops when one or more liver functions are impaired, accompanied by metabolic disorders, intoxication, disorders of the central nervous system and the development of hepatic coma. The disease occurs with symptoms of hepatocellular insufficiency (jaundice, hemorrhagic, dyspeptic, edematous-ascitic syndromes, fever, weight loss) and hepatic encephalopathy (emotional lability, apathy, speech disorders, hand tremor, ataxia). The extreme degree of liver failure is the development of hepatic coma. Liver failure is detected on the basis of biochemical parameters of blood, EEG, hepatoscintigraphy. Treatment of liver failure is aimed at eliminating intoxication, normalizing electrolyte disorders, restoring acid-base balance.

Liver failure can develop by an endogenous, exogenous or mixed mechanism. The basis of endogenous insufficiency is the death of hepatocytes and the shutdown of more than 80% of the hepatic parenchyma from functioning, which is usually observed in acute viral hepatitis, toxic liver damage. The development of exogenous liver failure is associated with impaired hepatic blood flow, which leads to the flow of blood saturated with toxic substances from the portal vein immediately into the general circle, bypassing the liver. The exogenous mechanism is more common in bypass surgery for portal hypertension and liver cirrhosis. Mixed liver failure occurs when both pathogenetic mechanisms- endogenous and exogenous.

In the development of liver failure, three stages are distinguished: initial (compensated), severe (decompensated), terminal dystrophic and hepatic coma. In turn, hepatic coma also unfolds sequentially and includes the phases of precoma, threatening coma, and clinically pronounced coma.

Causes of liver failure

Next in frequency etiological factors liver failure are drugs and toxins. So, a massive lesion of the hepatic parenchyma can cause an overdose of paracetamol, analgesics, sedatives, diuretics. The strongest toxins that cause liver failure are the poison of the pale toadstool (amanitoxin), mycotoxin of fungi of the genus Aspergillus (aflatoxin), chemical compounds ( carbon tetrachloride, yellow phosphorus, etc.).

In some cases, liver failure may be due to liver hypoperfusion that occurs in connection with veno-occlusive disease, chronic heart failure, Budd-Chiari syndrome, and profuse bleeding. Liver failure may develop with massive infiltration of the liver tumor cells lymphoma, lung cancer metastasis, pancreatic cancer.

Rare causes of liver failure include acute fatty degeneration liver, autoimmune hepatitis, erythropoietic protoporphyria, galactosemia, tyrosinemia, etc. In some cases, the development of liver failure is associated with surgical interventions (portocaval shunting, transjugular intrahepatic portosystemic shunting, liver resection) or blunt trauma liver.

Factors provoking the disruption of compensatory mechanisms and the development of liver failure can be electrolyte imbalance (hypokalemia), vomiting, diarrhea, intercurrent infections, alcohol abuse, gastrointestinal bleeding, laparocentesis, excessive consumption of protein foods, etc.

Symptoms of liver failure

The clinical picture of liver failure includes syndromes of hepatocellular insufficiency, hepatic encephalopathy and hepatic coma. In the stage of hepatocellular insufficiency, jaundice, telangiectasia, edema, ascites, hemorrhagic diathesis, dyspepsia, abdominal pain, fever, and weight loss appear and progress. In chronic liver failure develop endocrine disorders accompanied by a decrease in libido, infertility, testicular atrophy, gynecomastia, alopecia, atrophy of the uterus and mammary glands. Violation of metabolic processes in the liver is characterized by the appearance of hepatic odor from the mouth. Laboratory tests at this stage of liver failure reveal an increase in the level of bilirubin, ammonia and phenols in the blood serum, hypocholesterolemia.

Treatment of liver failure

In liver failure, a diet with strict restriction or exclusion of protein is prescribed; at the precoma stage, tube or parenteral nutrition is provided.

Treatment of liver failure includes measures for detoxification, improvement of microcirculation, normalization of electrolyte disturbances and acid-base balance. For this purpose, large volumes of 5% glucose solution, cocarboxylase, panangin, vitamins B6, B12, essentiale, lipoic acid are injected intravenously. To eliminate ammonia intoxication and bind the ammonia formed in the body, a solution of glutamic acid or ornitsetil is prescribed.

To reduce the absorption of toxic substances, the intestines are cleansed with laxatives and enemas; prescribe short courses of broad-spectrum antibiotics and lactulose, which suppress the processes of putrefaction in the intestines.

With the development of hepatocellular coma, the introduction of prednisolone is indicated; in order to combat hypoxia, it is advisable to carry out oxygen inhalations, hyperbaric oxygenation.

For complex therapy liver failure is applied hemosorption, hemodialysis, UVI blood.

Forecast and prevention of liver failure

With timely intensive treatment of liver failure, liver dysfunction is reversible, the prognosis is favorable. Hepatic encephalopathy in 80-90% turns into terminal stage liver failure - hepatic coma. With a deep coma, a fatal outcome most often occurs.

To prevent liver failure, timely treatment of liver diseases, the exclusion of hepatotoxic effects, drug overdoses, and alcohol poisoning are necessary.

The symptoms of liver failure are the same in both women and men. Acute and chronic liver failure can eventually lead to hepatic coma if its signs are not recognized in a timely manner.

Liver failure is a complex of disorders of the organ that occurs due to a lack or total absence healthy functional hepatocytes. Occurs with massive degenerative processes taking place in the liver. Due to a violation of metabolic processes, encephalopathy occurs, which is a disruption of the brain due to intoxication with endogenous and exogenous poisons. About 300 processes take place in this organ, freeing the body of toxins. In case of complete liver failure, i.e. death of all hepatocytes, hepatic coma occurs, and then, after eight hours, death.

Symptoms of the disease

All liver diseases without appropriate treatment sooner or later lead to hepatic dystrophy, and it, in turn, leads to liver failure syndrome.

1. Jaundice

The first of the symptoms that is visible to the naked eye. The skin and mucous membranes of the mouth, nose, eyes, genitals acquire yellowish color due to the accumulation of bilirubin and biliverdin in them: from greenish to rich orange hues. Depending on the natural color of the skin, its shade changes, but in people who have a genetically isolated swarthyness, only yellowing of the sclera of the eyeballs will be visible. Jaundice occurs due to the accumulation of bile. Compression of the bile ducts provokes the accumulation of fluid in the gallbladder, which can cause hepatic colic, and then it enters the bloodstream due to dysfunction of hepatocytes.

1. Discoloration of feces

The brown tone of digested food is not caused by the original components at all, but by stercobilin, which is a derivative of the components of bile. Since bile can no longer be excreted into the intestines, the stool becomes pale yellow or beige.

1. urine color

As the kidneys try to excrete the excess bilirubin, the urine turns dark brown or yellowish brown, the color of the pigment being sought.

1. itchy skin

Uncontrollable itching appears, which is not relieved by any drugs, while eczema is not observed. It often starts with the feet and goes higher.

1. Gastrointestinal lesion

Violation of the functions of bile secretion negatively affects the course of the processes of assimilation of food. Nausea becomes a constant companion of the patient, and after eating without additional enzymes, vomiting appears.

Further degenerative processes in the intestines provoke a decrease or loss of appetite, as well as its distortion - the desire to eat obviously inedible foods. The situation is aggravated by diarrhea, which manifests itself at least three to four times a day.

1. Poisoning by internal toxins

The next stages of the disease imply a deterioration in the background of the death of liver cells that do not have time to recover or lyse in the normal way. The decay products of the body's own tissues, which were previously neutralized by the liver, now accumulate in healthy organs, disrupting metabolism. The body temperature rises, the patient feels weakness, pain in the joints and muscles. The temperature can rise to critical - 40C or stay within 37-38C. Acute processes give more pronounced symptoms of poisoning by metabolic products. Viral infections the liver can aggravate the general intoxication of the body due to increased release of the viral agent and cell destruction under the influence of viral parabiosis products.

1. Liver degeneration

A change in the structure of the liver is a natural consequence of the death of some of the cells. It is accompanied by an increase or decrease in the organ, depending on the type of ongoing processes.

An increase (hepatomegaly) is easily determined by palpation, confirmed by ultrasound of the abdominal organs. Common etiology of hepatomegaly - circulatory disorder, adhesions, blockage, necrosis of the blood vessels of the liver, cholestasis, the appearance and development of neoplasms - cancerous tumors, tubercles, purulent abscesses, etc.

A completely opposite picture is observed in liver cirrhosis, when functional tissue is replaced by connective tissue. The liver decreases in size, hardens, the surface becomes wrinkled,

1. Accumulation of fluid in the abdomen, or ascites.

Our body is permeated with blood vessels, a dense network penetrating into all structures of the body. But few people know about the presence of a second, lymphatic system, which we inherited from the most ancient ancestors on the way evolutionary development- the first creatures to land on land, not yet warm-blooded, but already having separate circulatory and lymphatic systems. Lymph washes all the cells of the body, being part of internal environment. In the case of destruction, clamping of the lymphatic vessels, the lymph seeps through their walls and accumulates in the cavities, respectively, if the outflow of lymph in the liver is disturbed, the fluid accumulates in the abdominal cavity. The body literally inflates, with external examination belly can easily be confused with pregnancy.

1. Circulatory disorders

Due to circulatory disorders in the liver, namely squeezing of blood vessels, pressure rises. The heart works for wear and tear, which leads to thickening of the walls, arrhythmias, bradycardia, etc. The walls of blood vessels cannot withstand pressure, fluid begins to effusion in the tissue, which causes swelling, and rupture of capillaries and blood vessels, which causes internal hematomas.

Vein dilation is a permanent symptom of all diseases that affect the circulatory system. In the case when the organs of the abdominal cavity are affected, the so-called spider veins appear on the shoulders, chest, abdomen. They are vessels extending from the portal veins, which compensate for the lack of blood circulation.

1. Enlargement of the spleen.

If the liver is switched off from the functionality of the body, the spleen takes over part of its functions. Due to circulatory disorders, pressure in the inferior vena cava and portal veins increases. This, in turn, causes the spleen to enlarge as it stores the body's blood.

1. Hematemesis

This is a manifestation of the rupture of the veins of the esophagus. The patient vomits clotted blood, sometimes the blood may become visible only in the stool. May be acute or intermittent.

1. Pulmonary edema

Against the background of portal hypertension, the pressure in all blood vessels increases, and sooner or later the lungs are affected by hypertension against the background of liver failure. Patients complain of shortness of breath, cough. Over time, the condition worsens, the blood vessels penetrating the alveoli burst. There is a cough with bubbling bright scarlet arterial blood.

Pulmonary edema can develop both quickly and very slowly, it all depends on the individual characteristics of the organism. This symptom is extremely dangerous, as it can cause respiratory arrest.

13. Hepatic encephalopathy

The last thing to take a toxic hit is the brain. Nervous system due to the existence of the blood-brain barrier, it is kept to the last, and failures in its work can lead to coma and even death. The classic symptoms of any encephalopathy are dizziness, lethargy, insomnia, impaired cognitive function, delirium, convulsions, disorientation in time and space, loss of sensitivity, hyperreactivity, psychosis, depression, etc.

A critical accumulation of toxins, tissue decay products and other substances harmful to the body in the blood can cause encephalopathy, and if left untreated, the so-called “hepatic coma”, which will inevitably lead to death.

Causes

For clarity, it is necessary to list the causes of liver failure:

Regardless of the etiology, development is the same and takes from two days to a week in the acute form and up to five years in the chronic form.

Pathogenesis and stages of the disease

It is really important for the diagnosis and treatment of liver diseases to know what processes take place in the depths of the body, causing certain consequences and to notice signs of liver failure in time. Pathological change acid-base balance and imbalance of electrolytes (decrease in the amount of potassium, sodium, chlorine ions in the blood, acidosis, alkalosis) provokes intoxication of the body, including the extreme symptom - hepatic encephalopathy.

The mechanics of development, or the pathogenesis of liver failure, is massive necrosis of liver cells. Necrosis develops as follows:

1. Hepatocytes are affected by a harmful agent. Cells begin to secrete enzymes that destroy dead hepatocytes and damage healthy ones along the way.
2. The immune system secretes bodies that attack damaged hepatocytes and completely destroy them.
3. The process extends to healthy tissue.
4. With the death of more than 70% of hepatocytes, symptoms of liver failure appear.
5. Metabolism cannot proceed normally. The liver can no longer store glycogen, synthesize urea and decompose ammonia, and it poisons the body.

The severity of symptoms depends on percentage functional and dead cells, as well as the rate of their death.

The disease is divided into three stages:

1. Initial. The compensated stage, which is characterized by an increased fight of the liver with an aggressive agent, whether it be a toxin, a virus, a bacterium, or a mechanical injury. Lasts from several hours to several months, depending on the strength of the damage;
2. Expressed or decompensated. Characterized by a sudden transition from the initial stage, a jump in temperature, sharp deterioration condition, onset of symptoms.
3. Terminal. Liver dystrophy, complete destruction of functional cells. Ends in hepatic coma, and within two days - death.

Types and forms of liver failure

The classification of liver failure divides its types into two branches: acute and chronic. Their differences lie in the length of time and the severity of symptoms. It is worth dwelling on their description in more detail.

Acute liver failure

In acute liver failure, the compression stage is absent or very short. The symptoms are pronounced. The development time is from several days to several weeks, without treatment it quickly leads to coma and death.

There is a closer to acute, more rapid course of the disease - fulminant (fulminant) liver failure. With such a development of events, liver failure occurs in 6-10 hours. The causes of such phenomena are intoxication with poisons, medicinal substances, insecticides, pesticides, etc.

Depending on the type and location of violations, several of its forms are distinguished:

1. Hepatocellular (endogenous) - characterized by massive focal lesions of hepatocytes caused by strong toxic effects (for example, poisons, drugs, etc.), acute hepatitis.
2. kzogennaya - provoked by nutritional deficiency as a result of pathologies of the blood supply. Violation of blood circulation in the liver or pathology of the veins that carry blood to it often occurs with cirrhosis. Blood circulates, bypassing the liver, poisoning all organs and systems of the body.
3. Mixed - combines both of the above forms and their symptoms, is characteristic of chronic and systemic diseases liver.

The course of the disease is always severe. Most often, acute deficiency is caused by the ingestion of a large dose of a toxic substance. Taking strong drugs, especially in combination with alcohol, after abdominal surgery or hepatitis A, B, C, D, E, F can also stimulate the development of the disease.

Chronic liver failure

Chronic liver failure develops slowly, against the background of a constant supply of hepatotoxic factors. Symptoms may not be noticeable at all or appear only in the last stages, after a long time (from 2 months to 6-10 years)

Initially, it may show signs of metabolic disorders, cholelithiasis, stomach upsets, which doctors do not associate with liver failure.

Chronic liver failure can be caused by alcoholism, hepatitis B and C, diabetes mellitus, and other disorders. endocrine system, autoimmune diseases

Forms chronic insufficiency identical with acute forms. Processes that depress liver activity for several years are much more difficult to correct and medical procedures. The most common form is cirrhosis of the liver, which manifests itself against the background of alcoholism. Daily ethanol intoxication leads to slow necrosis of functional tissues that cannot recover and their replacement.

Why is chronic liver failure so difficult to diagnose? All because of the extreme vitality of this remarkable gland. The liver has time to compensate for the damage, but some of the toxic substances circulate throughout the body for a long time, worsening the general condition of the body and causing complications of diseases that could not develop under other conditions. For example, if a person had a chance of developing arthritis due to working conditions, intoxication is guaranteed to increase that chance. He will come to the doctor and complain about the joints, although the original cause is in a completely different organ system.

Sooner or later, there comes a time when the liver, weakened by the chronic intake of toxins, is exposed to any additional hepatotoxic factors, and hepatocytes lose the opportunity to recover. Under such a combination of circumstances, encephalopathy and hepatic coma may occur.

What can lead to complications in chronic liver failure:

1. alcohol in any quantity;
2. Taking medicines in large doses;
3. Use a large number fatty and protein foods;
4. stress;
5. Infections affecting all body systems;
6. Pregnancy;
7. General anesthesia for operations.

This disease requires adherence to a diet and a course of procedures to detoxify the body.

The prognosis, as in acute insufficiency, is unfavorable: only 30% of patients have time to start treatment on time, and with encephalopathy and hepatic coma, the chances of survival are reduced to 10-15%.

Diagnostics

Diagnosis of liver failure is carried out only by a hepatologist, gastroenterologist or general practitioner.

Diagnostic methods include:

1. Complete blood count - it includes the measurement of hemoglobin, leukocytes and erythrocyte sedimentation rate.
2. Liver blood tests - determination of total bilirubin, the level of transaminases ALT, GGT and AST, thymol test, determination of the De Ritis coefficient. They give an idea about the level of liver tissue damage, the state of the biliary tract.
3. Biochemical blood test - determination of the amount of glucose, urea, protein, cholesterol, free and bound iron, ammonia in the blood.
4. Urinalysis - for diagnosis, the color, amount of urobilin and protein are of interest. With liver failure, the indicators increase tenfold, and the color becomes close to the color of dark beer.
5. A blood test for antibodies to hepatitis viruses - in the presence of antibodies, there is also a virus, which will tell doctors how to deal with this disease. With a weakened immune system, antibodies may not be present. , to identify a specific virus.
6. Abdominal ultrasound - instrumental method determining the size, density of the liver, the relief of its surface. Allows you to see tumors, tuberculous nodules and other neoplasms.
7. Computed tomography (CT) and magnetic resonance imaging (MRI) are the most accurate examination methods that clearly show the condition of the liver.
8. Liver biopsy - taking part of the biomaterial (liver tissue) for research. Allows you to see and evaluate the processes occurring with the liver tissue.

Treatment of acute and chronic forms

The most important thing for the successful treatment of liver failure is to recognize it in time. The following are quite logical recommendations, based on the above symptoms and causes.

1. It is necessary to adjust the daily routine for five meals a day, fractional meals.
2. Eliminate the source of chronic intake of harmful substances.
3. Follow a diet (in medicine it is called “table number 5” for people with a diseased liver.
4. Prevent the entry of toxic substances into the body. It implies a complete rejection of alcohol, drugs (except those prescribed by the attending physician), it is desirable to completely abandon bad habits.
5. Carry out procedures aimed at the speedy removal of toxins from the body.

Naturally, the relief of symptoms of acute liver failure is significantly different from the treatment of chronic.

Necessary measures for acute liver failure:

1. Detoxification: the introduction of solutions of sodium chloride, ac-salt, rheosorbilact or its analogues intravenously.
2. Protein-free diet: proteins are one of the sources of nitrogen, which, when decomposed by intestinal bacteria, is converted into ammonia. A diseased liver cannot convert ammonia into urea, and ammonia travels through the body along with the blood, poisoning the organs.
3. Ammonia elimination - application of glutamic acid and ornithine
4. Cauterization of ulcers - in case of hemorrhage of the esophagus, it is necessary to eliminate the bleeding, possibly surgically.
5. Drugs that help restore the liver: arginine, ornithine, hepatoprotectors (Essentiale, Hepa-Merz, etc.)
6. Sedatives, painkillers, antispasmodics - to calm the patient.
7. Ensuring the patency of the biliary tract, possibly with the help of surgery.
8. Fast-acting vasodilators and blood pressure lowering drugs.

All drugs are administered intravenously.

Treatment of chronic liver failure:

1. Search and relief of the underlying disease that caused liver failure.
2. Compliance with a strict diet throughout the treatment.
3. Symptomatic correction of metabolism based on individual results analyses.
4. Monitoring the state of the liver using instrumental methods.
5. Cleansing the intestines with enemas, lactulose preparations and drugs that inhibit the activity of microflora.
6. Conducting courses intramuscular injection vitamins to support liver recovery
7. Reception of hepatoprotectors.
8. Remember folk methods This disease has no cure!

Radical treatments

Accelerated and costly treatments include hemodialysis, plasmapheresis, and liver transplantation. general characteristics Plasmapheresis and hemodialysis is the purification of the blood from toxins outside the body. Hemodialysis conducts blood through the artificial kidney apparatus, and plasmapheresis drives plasma through special filters, leaving all harmful impurities on them. Plasmapheresis is better suited for the treatment of liver failure.

Liver transplantation is a complex and rather dangerous operation, used only in extreme cases. In order for the liver to take root, it is desirable consanguinity with a donor. The operation can end in death for both the donor and the patient. The organ is transferred directly, within a few minutes from the separation from the donor. A transplant is not completely required: a part of the liver is taken, and sutured to the diseased part, with the connection of all vessels and nerve endings. In Russia, such operations are carried out in the most extreme cases.

Diet and daily routine

To begin with, it is worth clarifying that if it is impossible to eat food - constant vomiting, nausea - nutrient solutions are administered intravenously, which constitutes the main “diet” of the patient for several days, until the doctors stabilize the condition.

The main purpose of the diet is to ensure the supply of essential minerals, vitamins, to maintain optimal water-salt balance and reduce the amount of ammonia released by bacteria.
For this there is special diet called "hepatic". It is worth noting that you should not arbitrarily change the diet for such ailments - the attending physician will tell you what to eat in your individual case.
The picture shows recommended and undesirable products for use in diseases of the liver and gastrointestinal tract.

To begin with, it is recommended to reduce protein intake to 40 grams per day (at the rate for a healthy person from 120 grams, when calculating 2.5 grams of protein per kilogram of body weight). Note that digestible protein is taken into account, and its amount varies in different protein products. Some patients feel calm when increasing the amount of protein to 60-80 grams per day. Remember, a long-term protein deficiency is fraught with metabolic disorders, hematopoiesis, muscle functionality, so the doctor will gradually bring it back to normal. Protein should be introduced gradually, starting with vegetable protein and over time, in the absence of a negative reaction, give meat and meat products.

It is advisable to eat foods that are good for the liver. We will tell you about them in another article.
It is necessary to ensure the maximum intake of all essential amino acids to accelerate liver regeneration. Amino acids are the building blocks of

Include bran and cereals in your diet - they will help cleanse the intestines.
To ease intoxication, you need to take lactulose, which reduces the absorption of nitrogen by intestinal bacteria.

A disease that is characterized by a violation of the integrity of the liver tissues due to their acute or chronic damage is called liver failure. This disease is considered complex, due to the fact that after liver damage, metabolic processes are disturbed. If you do not take appropriate measures to cure the disease, then under certain conditions, liver failure can quickly and rapidly develop and lead to death.

Classification

The disease is classified according to two criteria: the nature of the course and stages.

According to the nature of the course, two stages of the disease are distinguished:

• Acute;
• Chronic.

Acute liver failure occurs due to the loss of the ability of the liver to perform its functions. The disease manifests itself predominantly within a few days and is characterized by severe form course of symptoms. Often sharp look leads to death, so it is very important to know the symptoms in order to recognize the disease at an early stage.

Acute liver failure is subdivided into big and small. Big is classical form manifestations of the disease, which is quite clearly traced by clinical and laboratory studies. Malaya acute liver failure is more common in children against the background of serious illnesses (poisoning, intestinal infections, etc.). This subspecies is very difficult to diagnose due to the absence of symptoms of the disease. A small species can develop both rapidly and over several years.

Chronic liver failure develops through the slow course of the disease. Due to the gradual dysfunction of the liver with the progressive course of a chronic disease of the parenchyma, a chronic form of the disease is formed. Diseases such as or are the result of chronic liver failure. Both manifestations end in hepatic coma followed by death.

Additionally, there are two types of liver failure:

• endogenous;
• exogenous.

For endogenous species characteristic manifestation of complications during death or dystrophic changes in liver tissues. This species is characteristic of cirrhosis of the liver and chronic hepatitis.

exogenous species It is formed as a result of self-poisoning of the body, the cause of which are metabolic products and substances that are produced by the intestinal microflora. It occurs due to the entry of these substances into the blood through the walls of the intestine, when they stop in the liver. The reason for the stop can be a blockage of the veins, therefore, as a result, self-destruction of the liver is observed.

According to the severity, four stages are distinguished:

1. Initial or compensated, which is characterized by an asymptomatic course of the disease. At the initial stage, the liver begins to actively respond to toxins.
2. Decompensated. The first signs of the disease appear. At this stage, a blood test indicates the development of the disease.
3. Dystrophic or terminal. The pre-final stage, upon the onset of which the patient has serious violations functioning of the liver. Against the background of which there is also a violation of the work of the whole organism from the central nervous system to metabolism.
4. Stage hepatic coma . It is characterized by a deepening of liver damage, which ultimately leads to death. Last stage characterized by the complexity of treatment, as the liver passes into the stage of dying.

Causes of the disease

The disease "liver failure" is diagnosed in both men and women, moreover, it does not have age restrictions so you can get sick childhood as well as in the elderly. The causes of liver failure are varied and unpredictable. It is important to know them in order to be able to determine the diagnosis prematurely and speed up treatment. So, the reasons that can provoke liver failure in humans are as follows:

1. Liver disease, which include: malignant tumors and other neoplasms, cirrhosis, acute and chronic hepatitis, echinococcus, etc. Any of these signs can serve as an impetus for the development deadly disease. Cirrhosis and hepatitis can be both the cause of the disease and its consequences.
2. blockage bile ducts , as a result of which an increase in the pressure of biliary hypertension is predicted. Failure of hypertension disrupts blood circulation in the liver, which causes the development of dystrophic abnormalities in the cells of this organ.
3. Diseases of the heart, blood vessels, infectious infections of the body, insufficiency of the endocrine glands, autoimmune diseases. Any disturbance in the body can lead to the development serious illness, therefore, it is much easier to eliminate signs of deviations at an early stage than to try to recover from serious illnesses.
4. Taking medications(especially for a long time) can leave its mark on the liver. As you know, any medicine affects the liver, so it is very important to correct dosages drugs and do not violate the frequency of admission.
5. Poisoning by various substances organic and inorganic: poisonous mushrooms, alcohol, tobacco, chemicals, etc.
6. Extreme Influences. The cause of a fatal disease can be even a minor burn on the skin, to which the appropriate medical measures. In addition: trauma, blood loss, allergies, septic shock and other factors may be the root cause of liver failure.
7. Deviation in kidney function, urolithiasis, congenital anomalies and much more, are the causes of a disease such as renal and hepatic malaise.

The main cause of renal and hepatic disease is the lack of balance between constriction and expansion of blood vessels. The reason for the lack of balance can serve as a banal cause of alcohol abuse, as well as poisoning, both food and respiratory. The disease of renal-hepatic insufficiency is no less serious than damage to the liver alone, since an increase in mortality from this type of disease is observed every year.

Based on all the causes, a complex of symptoms of the disease manifests itself. What are these symptoms and their main features, we will consider in more detail.

Symptoms of the disease

The symptoms of liver failure are very diverse, but they are the first factors, after the discovery of which it is necessary to hurry to the doctor. The initial stages of the disease are manifested in the form of a general malaise of the body, the appearance of mania and other motor disturbances. During flexion / extension of the fingers, a tremor symptom may be observed, that is, lateral signs or trembling, which often occurs with sudden movements.

Liver failure and its symptoms are always accompanied by the development of neuritis. The patient has a rise in temperature to the level of 40 degrees with an exacerbation of the disease, as well as swelling of the legs. An unpleasant but specific odor arises from the mouth, indicating the beginning of the formation of trimethylamine and dimethyl sulfide. There is a disorder of the endocrine system, there is an increase in hair loss, up to baldness, libido decreases, atrophy of the uterus and mammary glands occurs in women, stratification and crumbling of nails. In women, liver failure at an early age can adversely affect fertility, that is, provoke development.

In addition, during the entire period of the disease, the patient has an increase in headaches, feverish manifestations, dizziness up to fainting and an aggressive state. Let us consider in more detail what symptoms are inherent in the three stages of the disease.

Stages of chronic liver failure

Often, chronic liver failure is characterized by four stages, which have their own symptoms.

1. Compensated stage it often manifests itself asymptomatically, but the following negative processes are observed inside the body: an increase in pressure in the hepatic system, overflow of the venous plexuses on the abdomen,. At the initial stage, you can notice an indistinct appearance on the patient's body and reddening of the palms. The patient refuses to eat food, because of disgust. There is a slight weight loss.
2. Decompensated stage due to increased symptoms of the disease. The first signs of the disease begin to appear: aggression, disorientation in the area, slurred speech, trembling of the limbs. Relatives can observe a significant change in a person's behavior.
3. Dystrophic stage caused by stupor. The patient becomes inadequate, it is very difficult to wake him up, and in moments of wakefulness, apathy is periodically replaced by excitement. There are swelling of the face, legs, accumulation of fluid in the abdominal cavity. Also, the patient may appear in the morning or evening periods of bleeding from the nose or gastrointestinal tract.
4. At the final stage the patient has a hepatic coma, as a result of which the patient is unconscious, while there is no reaction to external pain stimuli. The patient's vision is reduced, strabismus develops, cerebral edema and fluid accumulation occur. Chronic liver failure develops in each individual case in different ways, often over decades.

Acute symptoms

Acute liver failure occurs predominantly rapidly with a pronounced picture of symptoms. This species has the following symptoms:

• sudden onset of weakness
• nausea, vomiting and other signs similar to poisoning;
• increase in body temperature;
• an increase in jaundice, while you can observe a change in skin color to yellow. eyeballs the patient also becomes yellow;
• smell from the mouth;
• a decrease in the size of the liver, which manifests itself in the form of pain symptoms;
• lethargy, anxiety and speech impairment.

Acute liver failure is characterized by a change in the composition of the blood: an increase in bilirubin occurs, which indicates decay and its decrease, as well as a decrease in the prothrombin index.

It is very important to deliver the patient to the clinic on time in order to be able to take medication. Otherwise, acute liver failure can be fatal in the shortest possible time.

Symptoms of kidney disease

The symptoms of renal and hepatic disease are almost identical to the above, only the only difference is the damage to the kidneys, which indicates their pain and the manifestation of the following signs:

1. The presence of pain first in the liver, and then in the kidneys.
2. Temperature increase.
3. Signs of jaundice.
4. In the urine, erythrocytes, protein and bile components are found.
5. Hemorrhagic diathesis is formed, the cause of which is intoxication of the body.

The main danger of a renal-hepatic disease is the involvement of other organs and systems in the process of pathology: the gastrointestinal tract, central nervous system, respiratory organs, etc. When chronic form there is a stop in the working capacity of the liver tissues, as a result of which toxins begin to be excreted through the gastrointestinal tract and lungs. This is an abnormal condition, so the body is under severe stress.

Before starting treatment, it is important to correctly diagnose the disease. See the next section for what you need to diagnose.

Diagnostics

If all of the above symptoms are found, then you should immediately contact the hospital or call an ambulance. The clinic will require diagnostics to be able to correct setting diagnosis. First of all, the diagnosis begins with a survey and examination of the patient. Often this is not enough to make a correct diagnosis, so the doctor will prescribe clinical measures.

Clinical activities include blood donation to identify biochemical data for bilirubin, alkaline photophase, LDH, AST and ALT. According to these indicators, the doctor reveals not only the presence of signs of the disease, but also at what stage the liver disease is. The higher the indicators, the more active the process of decay of liver cells.

An important place in the treatment process is given to infusion therapy, through which proper nutrition is provided and the body is detoxified. It is also necessary to improve liver microcirculation, normalize or restore the balance of acid-base balance.

The patient is prescribed laxatives and enemas to cleanse the gastrointestinal tract of toxins and get rid of constipation. A dropper with a solution of glucose, vitamins B6, B12, and lipoic acid entered daily.

If the disease has passed into the stage of hepatic coma, then they resort to intensive drug treatments. The purpose of these measures is to keep the patient alive so that hepatic function can return to normal. A solution of sodium or potassium bicarbonate is introduced, and humidified oxygen is inhaled through a nasal catheter. If the pressure decreases, then albumin is administered intravenously.

The patient must be on inpatient treatment and under the care of nurses. In addition to medical procedures, the following conditions are met:

• daily monitoring of a blood test to determine the composition of albumin;
• urinary monitoring;
• pressure ulcer prevention;
• weighing daily.

Preparations of hypoammonemic effects can reduce the level of ammonia in the body.

If the patient has a connection with renal failure, then additional hemodialysis will be required in order to remove ammonia and other toxins from the blood, which in normal conditions rendered harmless by the liver. With edema or ascites, paracentesis is necessary, which will help remove excess fluid from the body.

In addition to all of the above, to normalize the liver, you will need to maintain proper nutrition, or rather, diet.

Diet

Diet in the treatment of liver disease is mandatory procedure, since the liver receives a significant blow precisely from malnutrition. The diet includes the following procedures:

1. Reducing the level of protein and fat to 30 grams per day, and carbohydrates to 300.
2. Eating Preferably plant food, which includes: fruits, vegetables, honey, compotes, jelly.
3. Eat food only in liquid or semi-liquid composition. At the same time, you need to eat little by little, but every 2 hours.
4. Eliminate salt from your diet altogether.
5. If there are no edema, then about 1.5 liters of fluid should be drunk per day.

diet plays important role in the treatment of liver failure, therefore, a complex effect will allow you to get rid of the symptoms of the disease and return to your previous healthy life.