黄疸英文培训课件

Jaundice

Definition：jaundice,oricterusreferstotheyellowappearanceoftheskin,scleralandmucousmembranesresultingfromanincreasedbilirubinconcentrationinthebodyfluids.

ClassificationHemolyticJaundiceHepatocellularJaundiceCholestaticJaundiceCongenitalJaundice

1.DependingonEtiologyClassificationUnconjugated

bilirubinincreasedjaundiceConjugatedbilirubinincreasedjaundice2.Dependingon

bilirubinEtiology1.Congenitalhemolyticanemia2.Posteriorityacquiredhemolyticanemia(autoimmunityhemolyticanemia,hemolyticdiseaseofnewborn,

posttransfusionhemolytic,Favism).MechanismAlargenumberoferythrocytedestroyedrapidlyAnemia,hypoxiaandtoxityoferythocytemetabolismproducts1.HemolyticJaundice

ClinicalManifestation

Mildjaundice,light

lemon,noskinitch.Acutehemolytis:fever,chill,headache,vomit,backache,anemia,acuterenalfailure.Chronichemolysis:anemiaandsplenomegaly.2.HepatocellularJaundice

EtiologyHepatocytedamage.MechanismImpairhepatocyte

uptaking,conjugatingandexcretingbilirubinClinicalManifestation

Skinandmucosa:lighttodeepyellow,mildskinitchTired,lossofappetiteHemorrhagictendency,ascites,coma.Primarydiseasemanifestation

3.CholestaticJaundice

EtiologyVirushepatitis,drugcaused,drughepatitis,primarybiliarycirrhosis.Obstructionofextrahepaticbileduct:narrow,obstruction,stone,inflammation,tumor.MechanismObstructioncausessmallbileductandbilecapillarybroken,conjugatedbilirubinrefluxtoblood.ClinicalfeaturesSkindarkyellow,yellowgreen.Skinitch,bradycardia,darkyellowofurine,feceslightyelloworclaycolor.4.CongenitalNonhemolyticJaundice

Duetothedeficiencyofthehepatocyteinuptaking,conjugatingandexcretingbilirubin.AccessoryExamination

1.Ultrasound2.Xray3.ERCP4.PTC5.CT6.MRI7.RadioNuclideExamination8.LiverBiopsyandLCAccompanyingSymptoms

Fever:acute

cholangitis,liverabscess,leptospirosis(钩端螺旋体病),septicemia（败血症）,lobarpneumonia,virushepatitis,acutehemolysis.AccompanyingSymptoms2.Upperabdominalsharppain:biliary

calculi,liverabscess.Rightupperabdominalsharppain,chill,highfever,jaundice.Hepatomegaly①Mildormoderate,softormoderatehard,smoothsurface.

②Obviousenlargement,hard,raggedsurface.Gallbladderenlargement:commonbileductobstruction,pancreasheadcarcinoma,commonbileductcarcinoma.

SplenomegalyAscite:serioushepatitisJaundiceisacommonsymptomandsigninclinicalwork,gettoknowthemechanismcanhelpusidentifydifferentkindsofjaundices.Hemolyticjaundiceisduetotherapidlydestroyederythrocyte,sotheUCB(Unconjugated

bilirubin)

increased.Hepatocellularjaundicereferstouptaking,conjugatingandexcretingbilirubin,sobothCBandUCB