2022年医学专题-肝性脑病英文PPT

HepaticEncephalopathy

（HE）DongXuan第一页，共二十页。Parts

DefinitionCausesHypothesisSymptomsandSignsExaminationsTreatment第二页，共二十页。severeliverdiseases.metabolicdisordercentralnervoussystemdisorder

mainclinicalsymptoms

disturbanceofconsciousnessbehaviordisordercoma

points第三页，共二十页。DefinitionHEisacomplex,potentiallyreversibledisturbanceincentralnervoussystemthatoccursasaconsequenceofsevereliverdiseases.第四页，共二十页。CausesMainCirrhosisSeverehepatitisFulminantliverfailureSeverebiliaryinfectionAcutefattyliverofpregnancyperiod70%causedbycirrhosis

第五页，共二十页。PrecipitatingfactorsofHE1)GastrointestinalBleeding2)Abuseofsedativesandnarcotic3)Massiveparacentesisandexcessivediuresis4)InfectionsHypovolemia,shock,hypoxiaProteinbreakdownAmmoniaproduction benzodiazepinesandbarbituratesFluidorelectrolyteabnormalitiesandacidbasedisturbancetissuebreakdown第六页，共二十页。SeveralmainhypothesesAmmoniaIntoxicationFalseNeurotransmittersAminoAcidimbalanceTheGamma-AminobutyricAcidhypothesis第七页，共二十页。Symptoms(prodromalstage)Slightlyalteredmoodorbehaviors(precomastage)

Somnipathyandinappropriatebehaviors(lethargic

stage)Drowsy

andpsychopath(comastage)DeepcomacentralnervoussystemFourstagesofhepaticencephalopathy

第八页，共二十页。第九页，共二十页。FlappingtremorPatientB.Doctorandpatient第十页，共二十页。ClassificationLevelMentalStatusFlappingtremorⅠSlightlyWeakpositive

ⅡSomnipathyandPositiveinappropriateⅢDrowsyandPositivepsychopathⅣDeepcomaNegative

第十一页，共二十页。Examinations1)Bloodammoniachronic()acute()2)EEGslowsmallvalue3)PsychometrictestAdvantages:simple,noequipmentDisadvantage:influencedbyageandeducation第十二页，共二十页。Numberconnectiontest第十三页，共二十页。Graphicsconnectiontest第十四页，共二十页。Imagingexamination(CTorMRI)AcuteHE:CerebraledemaChronicHE:Encephalatrophy

第十五页，共二十页。Criticalfricker-fusionfrequencyThroughtestingtheretinalglialcelllesiontojudgethebrainastrocyteshaveswellingAdvantages:sensitive,simpleandreliable第十六页，共二十页。TreatmentPrinciples1）Eliminatingorcorrectingprecipitatingfactors2）Reducingplasmaammoniaandothertoxin3）Correctingplasmaaminoacidimbalanceandsupplyingnormalneurotransmitters第十七页，共二十页。4)Improvinghepatocytefunctions5)Livertransplantation第十八页，共二十页。Thankyou第十九页，共二十页。内容(nèiróng)总结HepaticEncephalopathy

（HE）。1)