What are the manifestations of impaired liver function in decompensated cirrhosis?

In general, the decompensated stage of liver cirrhosis indicates severe liver dysfunction that can no longer meet the body's normal physiological demands. Manifestations of impaired liver function mainly include abnormalities of the skin and mucous membranes, digestive and absorptive disorders, bleeding tendencies, endocrine disturbances, and neuropsychiatric abnormalities. A detailed analysis is as follows:

1. Skin and mucous membrane abnormalities: Reduced hepatic metabolism of bilirubin leads to its accumulation in the body, causing jaundice of the skin and sclera, with color ranging from light yellow to dark yellow. Additionally, spider angiomas may appear on the face, neck, and upper chest, while the thenar and hypothenar eminences of the palms may become red.

2. Digestive and absorptive disorders: Impaired liver function reduces the secretion of digestive enzymes, affecting food digestion and absorption. Patients often experience loss of appetite, nausea, and vomiting. After eating, slowed gastrointestinal motility and reduced digestive capacity can lead to abdominal bloating.

3. Bleeding tendency: The liver’s reduced ability to synthesize coagulation factors results in abnormal clotting function, making patients prone to gum bleeding and nosebleeds. Minor trauma or friction may cause petechiae or ecchymoses on the skin. In severe cases, gastrointestinal bleeding may occur, manifesting as melena or hematemesis.

4. Endocrine disturbances: In addition to disrupted estrogen metabolism, impaired liver function also reduces the inactivation of aldosterone and antidiuretic hormone. Accumulation of these hormones causes sodium and water retention, leading to lower limb edema, which may progress to generalized edema and possibly be accompanied by ascites.

5. Neuropsychiatric abnormalities: Toxic substances in the body cannot be effectively cleared by the liver and accumulate, affecting central nervous system function. Early symptoms may include fatigue, drowsiness, and difficulty concentrating. As the disease progresses, patients may develop disturbances of consciousness.

Patients should ensure adequate rest, avoid physical strain, maintain a light and easily digestible diet, strictly limit sodium and fluid intake, follow medical advice for hepatoprotective treatment, and undergo regular follow-up tests of liver function and related indicators to monitor disease progression.