利福昔明
肝性脑病
肝硬化
腹水
医学
乳果糖
胃肠病学
并发症
内科学
疾病
病理生理学
自发性细菌性腹膜炎
脑病
慢性肝病
炎症
肝病
重症监护医学
微生物学
生物
抗生素
作者
Dieter Häussinger,Radha K. Dhiman,Vicente Felipo,Boris Görg,Rajiv Jalan,Gerald Kircheis,Manuela Merli,Sara Montagnese,Manuel Romero‐Gómez,Alfons Schnitzler,Simon D. Taylor‐Robinson,Hendrik Vilstrup
标识
DOI:10.1038/s41572-022-00366-6
摘要
Hepatic encephalopathy (HE) is a prognostically relevant neuropsychiatric syndrome that occurs in the course of acute or chronic liver disease. Besides ascites and variceal bleeding, it is the most serious complication of decompensated liver cirrhosis. Ammonia and inflammation are major triggers for the appearance of HE, which in patients with liver cirrhosis involves pathophysiologically low-grade cerebral oedema with oxidative/nitrosative stress, inflammation and disturbances of oscillatory networks in the brain. Severity classification and diagnostic approaches regarding mild forms of HE are still a matter of debate. Current medical treatment predominantly involves lactulose and rifaximin following rigorous treatment of so-called known HE precipitating factors. New treatments based on an improved pathophysiological understanding are emerging.
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