肝疾病与门静脉高压症Liver diseases and Portal hypertension1of67第三十八章 肝疾病第一节 解剖生理概要(Anatomy and physiology)General Description and Topography2of67第三十八章 肝疾病第一节 解剖生理概要(Anatomy and physiology)Functional Anatomy3of67第三十八章 肝疾病第一节 解剖生理概要(Anatomy and physiology)Functional Anatomy and Surgery4of67第三十八章 肝疾病第一节 解剖生理概要(Anatomy and physiology)Functional Anatomy and Imaging5of67第三十八章 肝疾病第一节 解剖生理概要(Anatomy and physiology)Hepatic MicrocirculationMicrovilliHepatocytes in platesBile canaliculusSPACE OF DISSEFenestrated Endothelial cellsSINUSOIDKupffer cellSTELLATE CELLHEPATOCYTE ENDOTHELIAL CELL KUPFFER CELL STELLLATE CELL7of67第三十八章 肝疾病第一节 解剖生理概要(Anatomy and physiology)Blood Flow1500 mL/minute25% of the cardiac outputHepatic A.: Blood 25~30%, Oxygen 46~60%Portal v.: Blood 70~75%8of67第三十八章 肝疾病第一节 解剖生理概要(Anatomy and physiology)FunctionEnergy Functional heterogeneityBile formation Enterohepatic circulationBilirubin metabolism Carbohydrate metabolismLipid metabolism Protein metabolismVitamin metabolism CoagulationMetabolism of drugs and toxin Regeneration9of67第三十八章 肝疾病第一节 解剖生理概要(Anatomy and physiology)Assessment of Liver FunctionVariable 1 Point 2 Points 3 PointsBilirubin level <2 mg/dL 2–3 mg/dL >3 mg/dLAlbumin level >3.5 g/dL 2.8–3.5 g/dL <2.8 g/dLInternational normalized ratio <1.7 1.7–2.2 >2.2Encephalopathy None Controlled UncontrolledAscites None Controlled UncontrolledChild-Pugh class:Class A = 5–6 points; Class B = 7–9 points; Class C = 10–15 points Child-Pugh Score10 of67第三十八章 肝疾病第二节 偶发肝脏肿块的诊断与鉴别诊断（Occasional liver mass ）11 of67第三十八章 肝疾病第三节 肝脓肿（Liver abscess ）细菌进入肝的途径胆道肝动脉门静脉淋巴系统开放性肝损伤12 of67第三十八章 肝疾病第三节...
