HEPATITA CRONICA VIRALA

I.DIAGNOSTIC PARACLINIC

1.DIAGNOSTIC NESPECIFIC (INVESTIGATII UZUALE)

*citoliza hepatica-TGP,TGO;    *pigmenti biliari prezenti(intermitent)-Urob.↑

*retentie biliara-BT,BD;    -BC+

*colestaza hepatica-FA,γGT

*sdr.hepatopriv-albumina,colinesteraza,factorii de coagulare-Fg,

-IQ-Activitatea de protrombina

*sdr.de hiperactivitate mezenchimala-electroforeza proteinelor serice :- albumina, A/G

-gamaglobuline

*hemoleucograma,VSH

2.DIAGNOSTIC ETIOLOGIC-MARKERI VIRALI SEROLOGICI

*HBV-AgHBs *HCV-Ac anti HCV

*HVD-Ac totali anti HVD

-AgHBe -Ag HVD

-Ac totali anti HBc

-Ac anti Hbe

-Ac anti HBs

3.EXPLORARI IMAGISTICE

*Ecografie abdominala

*CT (computer tomograf) abdominal

4.CUANTIFICAREA INCARCATURII VIRALE

*AND-HVB;AND-HVD;ARN-HCV;

5.PUNCTIE BIOPSIE HEPATICA-PBH

II.TRATAMENT

1.Igieno-dietetic-evitarea eforturilor fizice mari;

-repaus fizic prelungit;

-regim alimentar de protectie hepatica;

2.Simptomatic-antiemetice,antispastice,antialgice,antiflatulente

-calmante prurit (anti H1,colestiramina )

3.Patogenic-PEV cu-solutii energetice-Glucoza 10%,5%;vitamine B1,B6,C,

-aminoacizi-Infesol,Aminosteril,Aminoven

-hepatoprotectoare-iv-Aspatofort,Arginina-Sorbitol

-hepatoprotectoare orale metaspar,hepatonplus,sargenor,LIV52,silimarina,farcovit,essentiale,acid orotic,antioxidant,polivitamine -Pharmaton,Supradyn

-coleretice-colebil,bilichol,metoclopramid

-vitamina K-in formele cu IQ↓,trombocitopenii,sangerari

-antisecretorii-anti H2-arnetin,quamatel,axid;IPP-omeprazol,pantoprazol;

4.Formele colestatice-Ursofalk,Bilichol,Fenobarbital,Colestiramina;Ampicilina

III.Durata medie de spitalizare-10 zile