{"id":3141,"date":"2020-05-01T00:00:00","date_gmt":"2020-05-01T00:00:00","guid":{"rendered":"http:\/\/localhost:8080\/invap\/?p=3141"},"modified":"2020-05-08T13:51:49","modified_gmt":"2020-05-08T16:51:49","slug":"cirrosis-hepatica","status":"publish","type":"post","link":"http:\/\/portal.imnytc-elalto.gob.bo:8080\/?p=3141","title":{"rendered":"Cirrosis hep\u00e1tica"},"content":{"rendered":"<p>Es una fibrosis progresiva, con caracter\u00edsticas destructivas de la gl\u00e1ndula hep\u00e1tica.<\/p>\n<h2>\u00bfC\u00f3mo se produce?<\/h2>\n<ul>\n<li>Hepatitis virales cr\u00f3nicas (B y C)<\/li>\n<li>Brucelosis<\/li>\n<li>Equinococosis<\/li>\n<li>S\u00edfilis cong\u00e9nita<\/li>\n<li>drogas (metotrexato, vitamina A, amiodarona, perhexilina, alfa metil dopa, oxifenacetina)<\/li>\n<li><a href=\"http:\/\/192.168.1.125\/IPS\/todo\/3139\/cirrosis-biliar-primaria\">Enfermedades autoinmunes<\/a> (hepatitis autoinmune)<\/li>\n<\/ul>\n<p>Las distintas causas producen lesi\u00f3n hep\u00e1tica de manera similar, esto es inflamaci\u00f3n cr\u00f3nica persistente, con formaci\u00f3n de fibrosis progresiva, hasta la conformaci\u00f3n de cirrosis.<\/p>\n<h2>\u00bfCu\u00e1les son sus signos y s\u00edntomas?<\/h2>\n<ul>\n<li>Fatiga (60 a 80 % de los casos)<\/li>\n<li>Agrandamiento del lado izquierdo del higado (60%)<\/li>\n<li>H\u00edgado peque\u00f1o (20%)<\/li>\n<li>Aumento del tama\u00f1o del bazo (50 a 75 %)<\/li>\n<li>Estigmas cut\u00e1neos (ara\u00f1as vasculares en el tronco, hematomas y palmas rojas)<\/li>\n<li>Calambres musculares<\/li>\n<li>Visualizaci\u00f3n de circulaci\u00f3n abdominal subcut\u00e1nea<\/li>\n<li>Aumento del tama\u00f1o de par\u00f3tidas<\/li>\n<li>Trastornos sexuales secundarios: \u00a0en hombres, aumento del volumen de las mamas, disminuci\u00f3n del tama\u00f1o testicular y en mujeres, irregularidades menstruales (dismenorrea)<\/li>\n<\/ul>\n<p><strong>Hallazgos bioqu\u00edmicos:<\/strong> disminuci\u00f3n del recuento de gl\u00f3bulos blancos y plaquetas, elevaci\u00f3n de las globulinas, trastornos de la coagulaci\u00f3n de la sangre con tendencia a hemorragias, elevaci\u00f3n de los indices de la funci\u00f3n renal.<\/p>\n<p><strong>Hallazgos radiol\u00f3gicos:<\/strong> aumento de tama\u00f1o del bazo, h\u00edgado de aspecto nodular, bordes hep\u00e1ticos irregulares, l\u00edquido libre en cavidad abdominal.<\/p>\n<h2>\u00a0\u00bfCu\u00e1les son sus complicaciones?<\/h2>\n<ul>\n<li>C\u00e1ncer de h\u00edgado<\/li>\n<li>Infecci\u00f3n del l\u00edquido abdominal<\/li>\n<li>Hemorragia de venas esof\u00e1gicas<\/li>\n<li>Alteraciones cerebrales funcionales por insuficiencia hep\u00e1tica<\/li>\n<li>Insuficiencia renal.<\/li>\n<\/ul>\n<h2>\u00bfCu\u00e1l es su tratamiento?<\/h2>\n<p>En cirrosis descompensada, se debe realizar el control efectivo del sangrado esof\u00e1gico, uso de diur\u00e9ticos, alb\u00famina, lactulosa y\u00a0anti\u00e1cidos,. Reducci\u00f3n del aporte de l\u00edquidos y\u00a0prote\u00ednas. \u00a0Adecuado soporte nutricional. Administraci\u00f3n de rifaximina por via oral y evacuaci\u00f3n del l\u00edquido abdominal.<\/p>\n<h2>Factores desencadenantes de fallo hep\u00e1tico en el paciente con cirrosis<\/h2>\n<ul>\n<li>Deshidrataci\u00f3n por diarreas o v\u00f3mitos<\/li>\n<li>Aumento de la ingesta de proteinas<\/li>\n<li>Constipaci\u00f3n<\/li>\n<li>Insuficiencia renal<\/li>\n<li>Transfuciones de sangre<\/li>\n<li>Infeccion del l\u00edquido abdominal<\/li>\n<li>Extracci\u00f3n del l\u00edquido abdominal, sin reposici\u00f3n de albumina<\/li>\n<li>Hemorragias digestivas<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Es una fibrosis progresiva, con caracter\u00edsticas destructivas de la gl\u00e1ndula hep\u00e1tica.<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[40],"tags":[48,53],"author_data":{"name":"","url":"http:\/\/portal.imnytc-elalto.gob.bo:8080\/?author=4"},"featured_media_data":{"thumbnail":{"url":null,"width":null,"height":null,"is_intermediate":null},"medium":{"url":null,"width":null,"height":null,"is_intermediate":null},"medium_large":{"url":null,"width":null,"height":null,"is_intermediate":null},"large":{"url":null,"width":null,"height":null,"is_intermediate":null},"1536x1536":{"url":null,"width":null,"height":null,"is_intermediate":null},"2048x2048":{"url":null,"width":null,"height":null,"is_intermediate":null},"rpwe-thumbnail":{"url":null,"width":null,"height":null,"is_intermediate":null},"full":{"url":null,"width":null,"height":null,"is_intermediate":null}},"audio_data":[],"comments_number":"0 comentarios","categories_data":[{"id":40,"name":"Enfermedades A-Z","slug":"enfermedades-a-z","url":"http:\/\/portal.imnytc-elalto.gob.bo:8080\/?cat=40","description":"","parent":0}],"_links":{"self":[{"href":"http:\/\/portal.imnytc-elalto.gob.bo:8080\/index.php?rest_route=\/wp\/v2\/posts\/3141"}],"collection":[{"href":"http:\/\/portal.imnytc-elalto.gob.bo:8080\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/portal.imnytc-elalto.gob.bo:8080\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/portal.imnytc-elalto.gob.bo:8080\/index.php?rest_route=\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"http:\/\/portal.imnytc-elalto.gob.bo:8080\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=3141"}],"version-history":[{"count":2,"href":"http:\/\/portal.imnytc-elalto.gob.bo:8080\/index.php?rest_route=\/wp\/v2\/posts\/3141\/revisions"}],"predecessor-version":[{"id":9741,"href":"http:\/\/portal.imnytc-elalto.gob.bo:8080\/index.php?rest_route=\/wp\/v2\/posts\/3141\/revisions\/9741"}],"wp:attachment":[{"href":"http:\/\/portal.imnytc-elalto.gob.bo:8080\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=3141"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/portal.imnytc-elalto.gob.bo:8080\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=3141"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/portal.imnytc-elalto.gob.bo:8080\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=3141"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}