肝性脑病英文PPT课件.ppt

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,.,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,.,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,.,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,.,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,.,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,.,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,.,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,.,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,.,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,.,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,.,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,.,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,.,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,.,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,.,*,Hepatic Encephalopathy,（,HE,）,Dong Xuan,1,.,Parts,Definition,Causes,Hypothesis,Symptoms and Signs,Examination,s,Treatment,2,.,severe liver diseases,.,metabolic disorder,central nervous system disorder,main clinical symptoms,disturbance of consciousness,behavior disorder,coma,points,3,.,Definition,HE is a complex,potentially reversible disturbance in,central nervous system,that occurs as a consequence of severe liver diseases.,4,.,Causes,Main,Cirrhosis,Severe hepatitis,Fulminant liver failure,Severe biliary infection,Acute fatty liver of pregnancy period,70%caused by cirrhosis,5,.,Precipitating factors of HE,1)Gastrointestinal Bleeding,2)Abuse of sedatives and narcotic,3)Massive paracentesis and excessive diuresis,4)Infections,Hypovolemia,shock,hypoxia,Protein breakdown,Ammonia production,benzodiazepines and barbiturates,Fluid or electrolyte abnormalities and acid base disturbance,tissue breakdown,6,.,Several main hypotheses,Ammonia Intoxication,False Neurotransmitters,Amino Acid imbalance,The Gamma-Amino butyric,Acid hypothesis,7,.,Symptoms,(,prodromal stage,)Slightly altered mood or behaviors,(,precoma stage,),Somnipathy and inappropriate behaviors,(,lethargic,stage),Drowsy,and psychopath,(,coma stage,),Deep coma,central nervous system,Four stages of hepatic encephalopathy,8,.,9,.,Flapping tremor,Patient,B.Doctor and patient,10,.,THANK YOU,SUCCESS,2025/4/3 周四,11,.,Classification,Level Mental Status Flapping tremor,Slightly Weak positive,Somnipathy and Positive,inappropriate,Drowsy and Positive,psychopath,Deep coma Negative,12,.,Examinations,1)Blood ammonia chronic()acute (),2)EEG slow small value,3)Psychometric test,Advantages :simple,no equipment,Disadvantage:influenced by age and,education,13,.,Number connection test,14,.,Graphics connection test,15,.,Imaging examination(CT or MRI),Acute HE :Cerebral edema,Chronic HE:Encephalatrophy,16,.,Critical fricker-fusion frequency,Through testing the retinal glial cell lesion to judge the brain astrocytes have swelling,Advantages:sensitive,simple and reliable,17,.,Treatment,Principles,1,）,Eliminating or correcting precipitating factors,2,）,Reducing plasma ammonia and other toxin,3,）,Correcting plasma amino acid imbalance and supplying normal neurotransmitters,18,.,4),Improving hepatocyte functions,5)Liver transplantation,19,.,Thank,you,20,.,THANK YOU,SUCCESS,2025/4/3 周四,21,.,