Abrahamovych M. Liver cirrhosis: characteristic of somatic polyorganic injury and principles of its differential treatment

The thesis presents the theoretical synthesis and resolution of current scientific issues - to improve the diagnosis, classification and treatment of liver cirrhosis including causes, severity of liver injury, and its co- and polymorbidic syntropic syndromal and nosological lesions, in pathogenesis of which the autonomic and endothelial dysfunction is participating. Based on the results of comprehensive examination of the liver in patients with cirrhosis, during 2005-2012, for the first time, we have defined the severity criteria of liver injury, as an integrative indicator of hepatocellular failure and portal hypertension, the degree of which was verified by advanced noninvasive ultrasound Doppler-floumetric examination. Based on complex clinical, laboratory and instrumental rating of affection of other organs and organ systems, we have found concomitant diseases, have formed the group of pathogenetically related with liver cirrhosis - syntropic, co- and polymorbidic syndromal and nosological lesions and have found possible pathogenic mechanisms of their detection. For the first time classification criteria of liver cirrhosis were justified. Besides the assessment of liver injury, considering extrahepatic syntropic lesions of other organs and organ systems, we make it possible to establish the functional class of the cirrhotic patient, that help us to determine prognosis, to formulate the concept of the diagnosis consideration. For the first time the treatment regimens for cirrhotic patients were optimized, according to the special algorithm, created by us, with a comprehensive approach position, that, besides the influence on etiological factor, is differentiated into the syndrome of hepatocellular failure and portal hypertension, takes into account syntropic co- and polymorbidic lesions of other organs, organ systems and their complications.