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肝硬化患者怎么吃,您了解了吗?

2018-08-09 佚名 中国肝炎防治基金会乙肝绿色家园

肝硬化是一种常见的慢性肝病,可由一种或多种原因引起肝脏损害,肝脏呈进行性、弥漫性、纤维性病变。具体表现为肝细胞弥漫性变性坏死,继而出现纤维组织增生和肝细胞结节状再生,这三种改变反复交错进行,结果肝小叶结构和血液循环途径逐渐被改建,形成假小叶,经过一个相当长的时期(数年甚至数十年),使肝变形、变硬而导致肝硬化。

肝硬化是一种常见的慢性肝病,可由一种或多种原因引起肝脏损害,肝脏呈进行性、弥漫性、纤维性病变。具体表现为肝细胞弥漫性变性坏死,继而出现纤维组织增生和肝细胞结节状再生,这三种改变反复交错进行,结果肝小叶结构和血液循环途径逐渐被改建,形成假小叶,经过一个相当长的时期(数年甚至数十年),使肝变形、变硬而导致肝硬化。

肝硬化严重影响人类身体健康和寿命。在日常生活中,饮食不当可能加重病情,而合理安排饮食可以改善消化功能,控制病情发展,增加机体抵抗力,并促进肝细胞修复以及肝功能恢复。因此肝硬化患者应牢记以下几个原则:

1. 合理应用蛋白质

肝脏是全身重要功能蛋白的合成场所。当存在肝硬化时,肝脏就不能很好地合成蛋白质了,于是人体可能会发生凝血异常、浮肿及腹水等情况。肝硬化患者应食用优质蛋白,如鱼虾、瘦肉等,以补充营养,提高白蛋白水平,但也需谨防蛋白质摄入过量诱发肝性脑病。对于已经存在肝性脑病的患者,建议低蛋白饮食,首推少量植物蛋白如豆腐等,因为过量的蛋白可在肠道内产生冗余的氨,加重肝性脑病。

2. 供给适量的脂肪

有的肝硬化患者因胰腺功能不全、胆盐分泌减少、淋巴管或肝门充血等原因出现脂肪痢,对脂肪吸收不良,当出现上述症状时,应控制脂肪量,但如果患者没有上述症状,并能适应食物中的脂肪,为了增加营养、减少蛋白质分解,脂肪不易限制过严。值得注意的是,油炸类食品不易消化,容易引起脂肪肝,而且反复煎炸的食物油中有致癌物质,不利于预防肝癌,因此肝硬化患者应选择合理的脂肪来源,尽量避免油炸食品。

3. 合理食用糖类、淀粉类

在日常餐饮的米和面中已含足够的葡萄糖,且由于肝病患者糖代谢发生紊乱,高糖饮食会使血糖升高、多余的糖会转变成脂肪而储存在肝细胞中,形成脂肪肝,因此肝硬化患者忌高糖饮食。但肝硬化伴营养不良的患者需要补充适量的碳水化合物以减少蛋白质分解,可选择睡前加餐,摄入适量的糖类或淀粉类,以增加营养。

4. 摄入含锌、镁的食物

肝硬化患者普遍血锌水平较低,尿锌排出量增加,肝细胞内含锌量也降低,当饮酒时,血锌量会继续降低,因此应严禁饮酒,并适当食用瘦猪肉、牛肉、蛋类、鱼类等含锌量较多的食物。为了防止镁离子的缺乏,应多食用绿叶蔬菜、豌豆、乳制品和谷类等食物。

5. 补充维生素C

维生素C直接参与肝脏代谢,促进肝糖原形成。增加体内维生素C浓度,可以保护肝细胞的抵抗力及促进肝细胞再生。腹水中维生素C的浓度与血液中含量相等,故在腹水时应补充大量的维生素C。但需注意,肝硬化食管底静脉曲张的患者吃水果时应剥皮或榨成汁饮用。

另外,肝硬化患者如无腹水则不必特别限盐限水,若已经出现腹水则应低盐饮食,轻度腹水者每日吃盐不应超过5克,重度腹水或下肢水肿严重患者每日吃盐不应超过1克。

还需特别提示,肝硬化患者饮食宜细软,如果已经出现中度、重度食管底静脉曲张,应避免食用粗糙或坚硬的食物以防曲张静脉破裂出血。此时,应禁用冬笋、果仁、油炸食品,并提倡用餐少量多次、细嚼慢咽。

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    2018-08-14 jyzxjiangqin

    肝硬化患者如何治疗。

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=338554, encodeId=567a338554cc, content=肝硬化患者如何治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Tue Aug 14 12:02:25 CST 2018, time=2018-08-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046326, encodeId=29c11046326c9, content=谢谢!最新的信息读起来就是收获大, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Fri Aug 10 01:56:00 CST 2018, time=2018-08-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337591, encodeId=bcf833e591e4, content=学习了,谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Thu Aug 09 23:34:07 CST 2018, time=2018-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337588, encodeId=778d33e588ae, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/30/21f1f0d02514796066d52523c747be51.jpg, createdBy=75a31960463, createdName=zdvfsadb, createdTime=Thu Aug 09 23:28:56 CST 2018, time=2018-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337581, encodeId=ba6833e58101, content=谢谢分享学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Thu Aug 09 23:05:42 CST 2018, time=2018-08-09, status=1, ipAttribution=)]
    2018-08-10 guging

    谢谢!最新的信息读起来就是收获大

    0

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    2018-08-09 惠映实验室

    学习了,谢谢分享。

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=338554, encodeId=567a338554cc, content=肝硬化患者如何治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Tue Aug 14 12:02:25 CST 2018, time=2018-08-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046326, encodeId=29c11046326c9, content=谢谢!最新的信息读起来就是收获大, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Fri Aug 10 01:56:00 CST 2018, time=2018-08-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337591, encodeId=bcf833e591e4, content=学习了,谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Thu Aug 09 23:34:07 CST 2018, time=2018-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337588, encodeId=778d33e588ae, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/30/21f1f0d02514796066d52523c747be51.jpg, createdBy=75a31960463, createdName=zdvfsadb, createdTime=Thu Aug 09 23:28:56 CST 2018, time=2018-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337581, encodeId=ba6833e58101, content=谢谢分享学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Thu Aug 09 23:05:42 CST 2018, time=2018-08-09, status=1, ipAttribution=)]
    2018-08-09 zdvfsadb

    学习了

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=338554, encodeId=567a338554cc, content=肝硬化患者如何治疗。, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Tue Aug 14 12:02:25 CST 2018, time=2018-08-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046326, encodeId=29c11046326c9, content=谢谢!最新的信息读起来就是收获大, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Fri Aug 10 01:56:00 CST 2018, time=2018-08-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337591, encodeId=bcf833e591e4, content=学习了,谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Thu Aug 09 23:34:07 CST 2018, time=2018-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337588, encodeId=778d33e588ae, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/30/21f1f0d02514796066d52523c747be51.jpg, createdBy=75a31960463, createdName=zdvfsadb, createdTime=Thu Aug 09 23:28:56 CST 2018, time=2018-08-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=337581, encodeId=ba6833e58101, content=谢谢分享学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Thu Aug 09 23:05:42 CST 2018, time=2018-08-09, status=1, ipAttribution=)]
    2018-08-09 清风拂面

    谢谢分享学习

    0

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医生在做肠胃的某种操作时意外发现了肝硬化,除了“两对半”标志有慢性乙肝,血液病毒检查都阴性,肝功能正常,需要抗病毒治疗吗?

慢性乙肝肝硬化如何治疗 经典病例告诉您

患者于20年前健康查体发现HBV感染,肝功能异常,无纳差、乏力、恶心、腹胀等不适,给予保肝治疗后,肝功能正常。此后定期复查肝功各项指标均在正常范围,HBV-DNA定量未查。于两年前复查肝功能异常,HBV-DNA定量阳性,予“拉米夫定片”及保肝治疗,肝功能正常,HBV-DNA定量阴性。1年前停服“拉米夫定片”后肝功能又出现异常,HBV-DNA定量阳性,给予“拉米夫定片”及“阿德福韦酯片”联合治疗,病

Hepatology:在国际肝硬化队列中,饮食对肠道菌群的影响和对住院风险的调节是不同的

本研究表明,富含发酵牛奶、蔬菜、谷物、咖啡和茶的饮食与较高的微生物多样性有关。微生物多样性与90天住院治疗风险的降低有关。

Hepatology:对肝硬化患者的长期随访表明,MELD、年龄和BSA是死亡的主要预测因素

对肝硬化患者的长期随访表明,MELD、年龄和BSA是死亡的主要预测因素;在心血管参数中,左心房增大、心率和E/ E增加、平均血压降低是死亡的独立预测因子。

肝硬化误诊为肝癌 险酿大错

患者,男性,56岁,因腹胀三周,发热一周入院,患者三周前无明显诱因出现腹胀,伴有上腹痛,呈持续性隐痛,右侧明显,伴有恶心,厌食,无呕吐,腹泻,一周前出现发热,体温在37~38℃之间,无咽痛、流涕、咳嗽等上呼吸道感染症状,无胸痛、气短,无尿频、尿急、尿痛、腰痛。

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