肝性脑病英文课件

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1、HepaticEncephalopathy（HE）DongXuanPartsDefinitionCausesHypothesisSymptomsandSignsExaminationsTreatmentsevereliverdiseases.metabolicdisordercentralnervoussystemdisordermainclinicalsymptomsdisturbanceofconsciousnessbehaviordisordercomapointsDefinitionHEisacomp

2、lex,potentiallyreversibledisturbanceincentralnervoussystemthatoccursasaconsequenceofsevereliverdiseases.CausesMainCirrhosisSeverehepatitisFulminantliverfailureSeverebiliaryinfectionAcutefattyliverofpregnancyperiod70%causedbycirrhosisPrecipitatingfactorsofHE

3、1)GastrointestinalBleeding2)Abuseofsedativesandnarcotic3)Massiveparacentesisandexcessivediuresis4)InfectionsHypovolemia,shock,hypoxiaProteinbreakdownAmmoniaproductionbenzodiazepinesandbarbituratesFluidorelectrolyteabnormalitiesandacidbasedisturbancetissuebr

4、eakdownSeveralmainhypothesesAmmoniaIntoxicationFalseNeurotransmittersAminoAcidimbalanceTheGamma-AminobutyricAcidhypothesisSymptoms(prodromalstage)Slightlyalteredmoodorbehaviors(precomastage)Somnipathyandinappropriatebehaviors(lethargicstage)Drowsyandpsychop

5、ath(comastage)DeepcomacentralnervoussystemFourstagesofhepaticencephalopathyFlappingtremorPatientB.DoctorandpatientClassificationLevelMentalStatusFlappingtremorⅠSlightlyWeakpositiveⅡSomnipathyandPositiveinappropriateⅢDrowsyandPositivepsychopathⅣDeepcomaNegat

6、iveExaminations1)Bloodammoniachronic()acute()2)EEGslowsmallvalue3)PsychometrictestAdvantages:simple,noequipmentDisadvantage:influencedbyageandeducationNumberconnectiontestGraphicsconnectiontestImagingexamination(CTorMRI)AcuteHE:CerebraledemaChronicHE:Enceph

7、alatrophyCriticalfricker-fusionfrequencyThroughtestingtheretinalglialcelllesiontojudgethebrainastrocyteshaveswellingAdvantages:sensitive,simpleandreliableTreatmentPrinciples1）Eliminatingorcorrectingprecipitatingfactors2）Reducingplasmaammoniaandothertoxin3）C

8、orrectingplasmaaminoacidimbalanceandsupplyingnormalneurotransmitters4)Improvinghepatocytefunctions5)LivertransplantationThankyou