一位肝硬化病人因腹水和周邊水腫入院。護理師理解這些症狀主要與哪種生理變化有關？
A client with cirrhosis of the liver is admitted with ascites and peripheral edema. The nurse understands that these symptoms are primarily related to which physiological change?
- AIncreased portal venous pressure and decreased albumin synthesis✓ 正解門靜脈壓力增加與白蛋白合成減少
- BDecreased synthesis of clotting factors凝血因子合成減少
- CReduced bile production膽汁分泌減少
- DImpaired detoxification of ammonia氨解毒功能受損
肝硬化導致肝臟纖維化，阻礙肝臟血液流動，使肝門靜脈壓力升高（門脈高壓）。同時，受損的肝細胞合成白蛋白的能力下降。門脈高壓導致液體滲漏至腹腔（腹水），低白蛋白則降低血漿膠體滲透壓，加劇液體由血管滲入組織間隙（水腫）。
Liver cirrhosis causes hepatic fibrosis that obstructs blood flow through the liver, raising portal venous pressure (portal hypertension). At the same time, damaged hepatocytes have reduced capacity to synthesize albumin. Portal hypertension causes fluid to leak into the abdominal cavity (ascites), and hypoalbuminemia lowers plasma oncotic pressure, exacerbating the movement of fluid from the vasculature into the interstitial space (edema).
美國肝臟移植中心對肝硬化病人追蹤密切，護理師需教育病人飲食和藥物管理；台灣對於晚期肝病照護，安寧緩和醫療的討論較少，常延續積極治療。