肝性脑病bppt课件.pptVIP

Therapeutic principle Improvement of liver function. Cure the encephaledema（改善脑水肿） Artificial liver（人工肝） liver transplantation（肝移植） Question How to identified the minimal hepatic encephalopathy ? Which are common causes of HE?And how to treat ？ Analysis of the case Male,55 years old,suffered from Hepatitis B for about 5 years. recently the patient present abdominal distention gradually. In local hospital he was diagnosed as liver cirrhosis ,and was given diuresis to relieve symptom for half a month. three days ago, the patient present hematochezia，once per day，about 100ml. Yesterday he presented mind confusion .PE:BP100/60mmHg,drowsiness, the ability of orientation decreased，with spider angioma in anterior chest , abdominal muscle tension, rebound tenderness and shifting dullness positive. What’s the possible diagnosis? Summary Inducement Pathogenesis Clinical manifestation Diagnosis Management Thank you ! Hepatic encephalopathy肝性脑病 Department of Gastroenterology Third Xiangya Hospital WANG Xiaoyan, MD, PhD. Overview Etiology and Pathogenesis Pathology Clinical manifestation Laboratory examination Diagnosis and Differential diagnosis Management Contents of these classes: Overview（概述） Definition a series of reversible neurological and psychopathic syndrome caused by severe liver disease and Portosystemic shunt, and metabolic disorder is underlying change. Disturbance of consciousness /Coma Relative terms （相关概念） Minimal hepatic encephalopathy（MHE,轻微肝性脑病） The patient in this stage lack symptoms, which can be diagnosed by subtle Psychometric test . Portosystemic encephalopathy(门体分流性脑病) Etiology and Pathogenesis Etiology and Pathogenesis Various kinds of liver cirrhosis , portosystemic shunting(TIPS) are most common. Severe hepatitis, acute hepatic failure, primary liver cancer, gestation related fatty liver and severe biliary tract infection are also the etiological factors. Inducement Upper gastrointestinal hemorrhage (上消化道出血） Potent diuresis