肝性脑病bPPT.ppt

Hepatic encephalopathy肝性脑病;Overview Etiology and Pathogenesis Pathology Clinical manifestation Laboratory examination Diagnosis and Differential diagnosis Management;Overview（概述）;Relative terms （相关概念）;Etiology and Pathogenesis ;Inducement ;Pathogenesis （发病机制）; Neurotoxin hypothesis  Ammonia intoxication Change of neurotransmitter  γ-Amino-butyric acid hypothesis False neurotransmitter hypothesis Tryptophan;Intestine;How does ammonia cause neurologic dysfunction? Interfere with tricarboxylic acid cycle Increase concentration of aromatic amino acid Increase concentration of glutamine (Hypertonic );γ-Amino-butyric acid hypothesis GABA/BZ复合体学说（三） ;False neurotransmitter Hypothesis 假性神经递质;Tryptophan(色氨酸）;Pathology ;Pathology ;Clinical manifestation临床表现;Clinical manifestation;Symptoms（症状） ;Typical symptoms;Lethargy stage（昏睡期）: lethargy ,mental confusion and neural signs become more abnormal. EEG is abnormal significantly. Coma stage（昏迷期） :light or deep coma flapping tremor and reflex are lose. abnormal EEG is more significant.;LFT Blood ammonia testing(血氨） EEG: slower rhythms and triphasic waves Psychometric test（心理智能测验） Imaging examination Evoked potentials（诱发电位） ;1;Diagnosis Differential diagnosis ;Diagnosis;Differential diagnosis;Management 治 疗 ;Removing the inducement（消除诱因）;Drug therapy （药物治疗）;Therapeutic principle ;Question;Analysis of the case;Summary;Thank you !