Control liver lesions before canceration
Liver cancer is called "the king of cancer" because of its high mortality. As we all know, hepatitis causes cirrhosis and develops into liver cancer, which is a trilogy of liver cancer. Hou Jinlin pointed out that every 10 population in Guangdong Province has hepatitis B, and every 5 people have 1 fatty liver. The fate of patients with liver disease can be changed by "finding out" those who are potentially dangerous to cause cirrhosis among hepatitis patients for treatment.
"Every year, 5% of patients with liver cirrhosis will progress to liver cancer," Guo Yabing, director of the Liver Cancer Center of Southern Hospital, pointed out that patients with hepatitis should have regular check-ups, standardize antiviral treatment, prevent the development of liver cirrhosis and reduce cancer caused by viral factors. "B-ultrasound+fibrosis test" can find liver cirrhosis as early as possible, while "B-ultrasound+AFP test" can find liver cancer as early as possible, and it needs to be checked every six months 1 time.
Guo Yabing pointed out that every step can effectively prevent or block the process of liver cancer before it becomes cancerous. For example, before hepatitis develops into cirrhosis, many hepatitis patients are inactive. Doctors can choose a plan according to the situation, and completely block the development of hepatitis to cirrhosis through one year or even three to five years. Even if patients find liver cirrhosis late, they can be treated with standardized antiviral therapy to prevent the development of liver cirrhosis and reduce the risk of cancer caused by viral factors. At this time, patients should detect liver cancer early through regular monitoring.
"Early liver cancer is better than hepatitis B." Guo Yabing said that hepatitis B is a chronic disease and it is difficult to cure it. However, in the early stage of liver cancer, when the tumor is less than 3 cm, surgery is performed, and the postoperative effect is very good. Guo Yabing said that according to the statistics of inpatients with liver cancer in the hospital last year, only 5% of patients with early liver cancer were treated, and 46% and 44% of patients with stage II and III were deplorable.
How long can the prognosis of advanced liver cancer surgery live? Guo Yabing said that if it is advanced liver cancer, surgery can only live for about half a year, while 70% of people with early liver cancer surgery can live for more than five years. Hou Jinlin said that after the early and timely detection of liver cancer, the work of clearing the tumor is a minor operation. The liver cancer tumor can be "burned" through the probe, and the patient can be discharged from the hospital on the day after surgery. But if you don't check it regularly, it will be a big tumor when the liver area is painful. In the advanced stage, even liver transplantation is difficult to treat.
high risk group
Men over 40 should have their liver examined.
The liver is a silent organ. How to find its abnormal state as early as possible? Hou Jinlin suggested that mainly by physical examination, "readers must have this awareness and take the initiative to manage their own health and chronic diseases."
Guo Yabing suggested that people over 40 must have a physical examination every year. "Doing a physical examination every year is equivalent to eating a meal. This meal is equivalent to health care for my body. It is best to have nothing to do, treat it early, and spend the least money to do the biggest thing, with the greatest effect. " Guo Yabing said, but China people often have a kind of psychology, as if nothing is wasted, which is the lack of people's awareness of health care.
Who does liver cancer "prefer"? Guo Yabing said that from an epidemiological point of view, men are more likely to get liver cancer than women, especially men over 40 years old should be more vigilant, and people who have been infected with hepatitis B and have a family history of liver cancer should be highly valued. People with chronic hepatitis who are not well controlled are also at high risk of cancer. He suggested that patients can make self-test scores according to their own conditions, and those who reach the high-risk level must be vigilant and have regular physical examinations.
Stay alert
15% patients with fatty liver progress to cirrhosis.
With the growth of age, many middle-aged men gradually appear fatty liver with beer belly, which is also commonly known as "fatty liver". "Fortunately, I have fatty liver, not hepatitis B." Many patients with fatty liver have such luck after learning the news of illness. In fact, we can't treat fatty liver lightly.
Chen Jinjun, head of the multidisciplinary writing group of liver in Southern Hospital, said that fatty liver can lead to hepatitis. If you have hepatitis, you have a chance to get cirrhosis, and if you have cirrhosis, you have a chance to get liver cancer. According to Chen Jinjun's investigation of physical examination, fatty liver patients account for 22.6%, with an average of one in every five people. Among these patients with fatty liver, 33.9% of them have elevated liver enzymes.
In routine physical examination, the lack of GGT detection leads to insufficient prevention of steatohepatitis. Chen Jinjun pointed out that even if the transaminase is not high, if you gain weight 10 kg within one year, you will easily turn fatty liver into hepatitis by frequent drinking or intestinal infection.
Although steatohepatitis is reversible, it is also found that 15% patients with fatty liver can progress to irreversible cirrhosis within 5~25 years. Compared with the trilogy "Hepatitis B-Cirrhosis-Liver Cancer", "Fatty Liver-Cirrhosis-Liver Cancer" is a dance of "slow three Step", but some patients skip cirrhosis and jump to the stage of liver cancer in two steps.
remind
Patients with fatty liver had better take 10,000 steps every day.
The symptoms of liver cirrhosis caused by fatty liver are different from those caused by hepatitis B. "When patients with hepatitis B reach the stage of cirrhosis, they can see at a glance that their faces are dark and thin. After cirrhosis, patients with fatty liver are still ruddy and obese. " Chen Jinjun said that in general, fatty liver slowly develops into cirrhosis, with an average age of 58. For example, in Britain, about 30% of patients with liver cancer develop from fatty liver.
Chen Jinjun said that the liver cancer of patients with fatty liver is bigger than that of patients with hepatitis B, and patients often progress to liver cancer in old age. After getting liver cancer, only 18% people can survive for one year. 13% patients with fatty liver have blood sugar, and the probability of getting diabetes is 3~5 times higher than that of ordinary people. In addition, due to high blood lipids, patients with fatty liver have a higher risk of cardiovascular and cerebrovascular diseases, and the risk of chronic kidney disease is 2 to 6 times that of ordinary people.
"Many people think that the liver is inflamed and needs rest, but steatohepatitis can't sit down and rest. Instead, it is necessary to reduce the intake of fat and consume and excrete excess fat in the liver by paying attention to diet and strengthening exercise. " Chen Jinjun said that for obese people, it takes 250 minutes of exercise every week, while for ordinary fatty liver patients, it is best to ensure 10,000 steps of exercise every day. In addition to exercise, it is more important to control your mouth and say "no" to foods with high calorie, sugar and oil. He said that he raised his hand in favor of the old people dancing square dance, as long as it didn't disturb the people. Because dancing can ensure the amount of exercise, which is beneficial to joints and digestion, fatty liver will also be alleviated.
Wrong idea
Only 34% patients with hepatitis B can take medicine on time.
In the past, people's illness depended on doctors, and the health of the liver depended on patients' sufficient self-management consciousness. Hou Jinlin said that in the past 30 years, there has been a major breakthrough in the treatment of liver disease. He believes that in the near future, the treatment of liver diseases will have greater development. For example, hepatitis B virus can be completely eliminated, hepatitis B has no drug resistance, its infectivity is suppressed, and even the incidence of liver cancer is greatly reduced. Good technology, patients lack self-management awareness, and patients with chronic liver disease have low compliance.
According to Hou Jinlin, only 34% of patients with hepatitis B in Linyi can insist on uninterrupted treatment, while 40% of patients discharged from hospital have problems after stopping taking drugs and are readmitted to hospital. Hou Jinlin suggested that all patients with liver disease should become self-managers. It is not enough to rely solely on doctors. Patients should know how to protect their liver, adopt comprehensive health care methods and reasonable payment system according to the natural history of disease occurrence and development, control the development of disease, improve the quality of life of patients, and effectively control medical expenses.
In addition to self-management, fatty liver, liver cancer and other diseases need multidisciplinary diagnosis and treatment (MDT), and cooperation is needed to formulate treatment plans for patients. For example, patients with liver cancer can turn to the MDT team composed of multidisciplinary experts such as liver disease, liver surgery, tumor, intervention, imaging, radiotherapy and even Chinese medicine, while patients with fatty liver often suffer from "metabolic syndrome" and need to turn to the multidisciplinary team composed of experts such as liver disease, endocrine and kidney disease.
Questions and answers
"Big Three Yang" mothers can also breastfeed.
Q: If the mother is healthy and the father is positive for transaminase, will the child born be healthy? Can Big Three Yang's mother support her children?
A: If the mother is healthy and the father is positive for transaminase, the child born should be injected with hepatitis B vaccine and immunoglobulin as soon as possible within the specified time to block the transmission of father and baby under double immunity. Regarding mother's breastfeeding, Guo Yabing said that hepatitis B is mainly transmitted through blood, and the virus content in breast milk is much lower than that in blood. Generally speaking, eating and drinking water will not infect hepatitis B unless there is an ulcer in the mouth. If the child is injected with hepatitis B vaccine and immunoglobulin after birth, the risk of suffering from hepatitis B is very low, so breastfeeding is also recommended. If the child has an ulcer in the mouth, in this case, breast milk can be temporarily interrupted, and then feeding can be continued until the child's oral ulcer is cured.
Fatty liver should eat less staple food.
Q: What aspects should we pay attention to in diet to protect the liver?
A: The diet plan should be adjusted according to the cause of liver disease and the health status of the liver. It is wrong to say that you can't eat beef because of liver disease. When viral hepatitis such as hepatitis B and hepatitis C progresses to the stage of liver cirrhosis, you should supplement enough protein, eggs, milk and meat, because patients with liver cirrhosis need to ensure adequate nutrition in order to promote the growth of liver cells. Patients with fatty liver should eat less staple food, less fat and not drink "old fire soup". Patients with fatty liver should pay more attention to hydration. It is recommended to drink 2000 ml of water every day. Patients aged 50 to 60 can drink four bottles of mineral water, and patients over 60 are slightly less than this. The urgent task for patients with alcoholic hepatitis is to give up drinking.
Antiviral therapy cannot stop by itself.
Q: When can I stop antiviral treatment for chronic liver disease?
A: Patients with chronic liver disease need antiviral treatment under the guidance of a specialist, and it is forbidden to stop taking drugs on their own. Patients with "Big Three Yang" should stop taking drugs at least two years after the seroconversion of E antigen, that is, at least two years after the appearance of E antibody.
Q: I happened to find out that I had hepatitis when I was in hospital, but I didn't feel it at that time. Did it work? My daughter was found to be a hepatitis virus carrier when she was 6 years old. Transaminase is relatively high now. What should I pay attention to?
A: There are many types of hepatitis, such as A, B, C, D and E. If you get acute hepatitis A, it won't have much influence afterwards. According to your description, I guess it should be hepatitis B. If it becomes an inactive carrier, that is, the so-called "small three-yang", if the B-ultrasound is checked once every six months, the results are normal and no special examination and treatment are needed, but patients with hepatitis B will have a greater chance of getting liver cancer in the future than healthy people. Because of your daughter's elevated transaminase, it is recommended to see a specialist as soon as possible.
Liver cysts will not become liver cancer.
Q: Can hepatic cyst become liver cancer?
A: Liver cysts are benign lesions and will not become liver cancer. Liver cysts are usually fine if they are small. If the liver function is affected by a large cyst, it needs treatment.