Liver encephalopathy sums up _'s general knowledge

Liver encephalopathy sums up _'s general knowledge
Summary Liver encephalopathy is also called hepatic coma or body encephalopathy of the door. It is develop, fail seriously liver function not to mean it by hepatopathy going on,with (or) Nervous system symptom and physical sign,etc. that extensive pieces of body appear while shorting out.
Cause of disease The cause of disease of liver encephalopathy is divided Acute liver encephalopathy: Such as breaking out, serious disease and virus hepatitis, medicine hepatitis, chemical medicines such as tetrachloromethane or poisoning hepatitis that the poisonous fungus caused, and acute gravidic fatty liver. Chronic liver encephalopathy: See liver cirrhosis, door - hepatocarcinoma, end latter stage of phlebothrombosis and any chronic hepatopathy of door of a of identical and postoperative, later period in the later period of various causes of disease.
Causing the inducement of liver encephalopathy can be summed up for three respects: Increase sources which includes nitrogen material and other poisonous substance such as ammonia,etc., such as enter excessive protein, digestive tract massive haemorrhage, nitrogen blood disease, oral ammonium salt, urea, methionine,etc.. Constipation is an unfavorable factor too, make the noxious substance discharge and slow down. Low potassium is when the alkalosis, NH4 + apt to turn NH3 into, cause ammonia poison, set the ascites free cause because of a large amount of diuresis often. Aggravate the damage to the hepatocyte, make liver function further fail. For example the operation, anaesthesia, sedative, some resist consumptive disease medicine, infecting and oxygen deficiency etc.. At the chronic hepatopathy, about half the number case can find liver inducement of encephalopathy.
Symptom (1) Encephalopathy behaves: Liver encephalopathy is mainly shown as consciousness obstacle, intelligence damaging, neural muscle function obstacle. Can be divided into moderate breeze according to the weight of symptom, physical sign.
Nervous system physical sign show as skin tension strengthen and tendon reflect hyperfunction, can present one burst of contractions of the ankle, pounce on kind trembling. Some patient do mischief face, blink, can present, suck, wait for elementary to reflect. As the condition is developed, can present a bunch of evidence of cone. Popping convulsions seriously occasionally. The neural areflexia in later period, present the state of relaxing all over.
Liver to get up disease, course of disease, display because of cause of disease, inducement, pathologic the intersection of foundation and different first encephalopathy. The breaking out hepatitis patient can enter to go into a coma within several days, passing, 2 grade, prognostic difference. When liver cirrhosis digestive tract massive haemorrhage or companion in later period is infected with seriously, the condition is developed and very fast. And when door - a of identical and postoperative or door body collateral circulation takes shape extensively, it is chronic repeatedly that can be shown as the breaking out wood is stiff.
(2) Hepatopathy behaves: Mainly shown as liver function fails, depleted, with pulse hyperbarism of the door. It is discredited and bleeding and is inclined to etc. that the former often displays jaundice, liver. Pulse hyperbarism is shown as the collateral circulation of the door - body takes shape, ascites, splenomegaly, the spleen function is hyperfunction on the door. Some patients have door - anastomosis history of body.
(3) Other: Including the manifestation of complications of different basic diseases and hepatopathy.
Check Hard to tell that can confirm liver encephalopathy to check in a certain clinical manifestation or a certain laboratory. Should confirm first whether there is encephalopathy that exists. The patient has unusual behavior of unconscious, spirit unusual and neural muscles. The electroencephalogram is a more sensitive inspection, can reveal that unusually change.
In every liver function is checked, SGOT, SGPT and BSP test as more sensitive test, thrombinogen time, serum albumin and gallbladder are red can reflect the severity of hepatopathy usually. Examine the blood plasma blood coagulation factor 2, or it is the index that the most useful liver function damages to combine the serum albumin. Brief hepatopathy on and cause the intersection of supersession and checking, having, examining the intersection of blood and ammonia, proportion, the intersection of cerebrospinal fluid (CSF) and glutamine, - the intersection of ketone and the intersection of fifth and 2 sour density,etc., BCAA/AAA of serum, disorderly. It is it other to investigate it is for except encephalopathies other,such as BUN, blood glucose, electrolyte,etc..
Ammonia of blood increases. Treat Should diagnose liver encephalopathy in early days, deal with. The treatment of liver encephalopathy is comprehensive, many links.
(1) Remove the inducement: Control these inducements can often prevent the development of liver encephalopathy effectively. For example it can be developed into liver encephalopathy after breaking massive haemorrhage that the oesophageal song one is intravenous, arrest blood, correct anaemia, removes the intestine and can prevent the emergence of liver encephalopathy to accumulate the blood etc. actively.
(2) Nutrition supports to treat, improve the hepatocyte function: Liver encephalopathy patient often loses the appetite, or already been in a coma, can't take food, far from meeting demands of organism only by the general intravenous infusion.
1. Diet: Should take carbohydrate as the core, prohibit protein, at least 3 days.
2. Water, electrolyte and acid-base balance.
3. Vitamin and energy mixture: Should offer various vitamins, such as thiamine, C, K. In addition, can give ATP, coenzyme A.
4. Plasma albumin: Gastrointestinal massive haemorrhage or put ascites cause liver at the encephalopathy, but quiet to drip the plasma albumin, 25- 50g time, can keep the glue oozing and pressing. It is favorable to supplement the repair of the hepatocyte of albumin too.
(3) Reduce or resist ammonia and other harmful substances short of moneyly, improve the brain cell function.
1. Reduce intestine production and absorption of inner ammonia and other harmful substance.
( 1) Lead rushing down or enema. ( 2) Change pH of the intestine, reduce the forming of NH3. ( 3) Antibiotic (penicillin, it is plain that the pioneer is mould) .
2. Reduce ammonia of blood, reduce and resist the false neurotransmission short of moneyly.
( 1) The ammonia medicine of blood falls. ( 2) Anticlockwise many bar. ( 3) BCAA.
3. Other while having brains edema, should give the dehydration treatment. In addition, the liver encephalopathy patient has hypoxemia disease, should give oxygen intake, have reports, the hyperbaric oxygen treatment can make better result.
|