Take the first step1 current situation and treatment of hepatitis BIn 2006, the national hepatitis B serological epidemiological survey show
Take the first step
1 current situation and treatment of hepatitis B
In 2006, the national hepatitis B serological epidemiological survey showed that the positive rate of HBsAg in the general population was 7.18%. Chinese chronic HBV infection number about 100 million, of which more than 2000 cases of patients with chronic hepatitis B. Nearly 300 thousand cases of liver disease related to hepatitis B were killed every year in china. The treatment of chronic hepatitis B mainly including antiviral, immunomodulatory, anti-inflammatory and hepatoprotective, anti fibrosis and symptomatic treatment, antiviral treatment is the key. China's "chronic hepatitis B prevention and treatment guidelines" clearly put forward the target for the treatment of chronic hepatitis B: to minimize or eliminate long-term suppression of HBV, reduce the inflammation of the liver necrosis and fibrosis, delay and prevent the progression of the disease, reduce and prevent the occurrence of hepatic decompensation, liver cirrhosis, HCC and complications, so as to improve the quality of life and prolong the survival time. The current anti HBV treatment has made considerable progress, and many patients have been effectively controlled by antiviral therapy.
2 in the long course of treatment of hepatitis B patients, will encounter this or that hinder the rapids, such as the excessive anxiety leads to decreased immunity, when the resistance does not know how to deal with (here, with several characteristics of the disease described the difficulties and puzzles of hepatitis B patients in the treatment of common hepatitis B)
Chronic hepatitis B is caused by hepatitis B virus persistent infection of liver inflammation and necrosis, loss of appetite, fatigue in clinical manifestations, repeated abnormal liver function, if chronic progression of cirrhosis and hepatocellular carcinoma. Among them, viral replication is a major factor in the progression of chronic hepatitis B. It is because of the serious harm of chronic hepatitis, resulting in the patient in the treatment of a huge psychological and physiological pressure, often face many difficulties and confusion. If these problems can not be properly faced and solved, will seriously affect the patient's treatment effect. For example: the patient will not be infected by eating hepatitis to others? Hepatitis B virus can not be removed from the body? What is the ultimate goal of chronic hepatitis B treatment? Which patients must be treated with antiviral therapy, and which people do not need anti-virus treatment? Transaminase is normal or slight rise is the person that HBV infection wants to be treated with virus? What kind of antiviral therapy should be chosen? What are the problems that should be paid attention to when choosing antiviral drugs? How long is the nucleoside drugs treatment, whether can stop, what is the basis? How to deal with drug resistance? There is no need for joint antiviral therapy, how to choose? How does a woman with HBV infection have to block HBV infection in a fetus or infant? Hepatoprotective, anti fibrosis therapy is not more important than antiviral treatment? Wait。
3 how can we find a light life? It is the foundation and guarantee to choose the individualized treatment plan for science. In short, go on the first step, every step of the way. The so-called "walking to the first step" is to make a comprehensive evaluation on the basis of the characteristics of the disease...... How do you choose the initial treatment and what factors should be considered in determining the first treatment?
First of all, the establishment of a good relationship between doctors and patients is very important in the selection of treatment options. Some patients, often will continue to replace the doctor for treatment. The mood is understandable, but different treatment doctors may not be the same, so the treatment will bring the confusion, but ultimately a loss.
Next, the assessment of the disease, which is comprehensive, dynamic. It includes the patient is vertical transmission; fatigue, loss of appetite and other symptoms, degree of time and frequency; there is no hepatosplenomegaly, lower extremity edema, jaundice and other symptoms; how the blood tests of transaminase and bilirubin levels, is not repeated increased; two serum of HBV DNA is not half way, and so many positive index. Only a comprehensive evaluation, in order to develop a reasonable treatment plan, in order to determine whether the need for antiviral therapy. For example, patients in spite of hepatitis B immune markers positive, HBV DNA positive, but liver function has been normal, without any discomfort symptoms, such as fatigue, loss of appetite, there is no need for. But regular follow-up is necessary. If you have recurrent symptoms of fatigue, big world, more than 105 copies of the /ml HBV DNA, ALT = 2 * ULN, we must immediately start antiviral therapy such as ALT; < 2 * ULN, should make liver biopsy, liver histology showed that if Knodell HAI is greater than 4, or more than G2 of inflammation and necrosis. Should antiviral treatment.
Finally, determine the treatment of the patient and the doctor is to discuss the result should be the doctor advised, do not own.
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