肝性腦病英文

演講人：日期：肝性腦病英文目錄CONTENTSOverviewofHepaticEncephalopathyPathophysiologyofhepaticencephalopathyLaboratoryexaminationandauxiliarydiagnosisofhepaticencephalopathyTreatmentprinciplesandmethodsforhepaticencephalopathy目錄CONTENTSPreventivemeasuresandlifestylemanagementrecommendationsforhepaticencephalopathy01OverviewofHepaticEncephalopathyHepaticcoherence(HE)referstoasyndromeofcentralnervoussystemdysfunctioncausedbymultipleliverdiseases,characterizedbymetabolicdisordersDefinitionThepathogensisofHEinvolvementmultiplefactors,includingammoniatoxicity,neurologicalimbalances,andinflammatoryresponsesinthebrain,whicharetriggeredbylifefailurePathogenesisDefinitionandpathogenesisTheincidentandvalidityofHEvarydependingonthepopulationstudyandthecriteriausedfordiagnosisHowever,itisgenerallyconsideredtobeacommonapplicationofadvancedlivediseaseIncidentandvalidityRiskfactorsforHEincludemultiplelifedisorders,portalhypertension,andcertainprecisioneventssuchasgastrointestinalbleeding,infection,andelectrolytedisturbancesRiskfactorsEpidemiologicalcharacteristicsClinicalpresentationsandclassificationTheclinicalpresentationsofHErangefromsubtitleneurologicalchangestoovercomaEarlysymptomsmayincludepersonalitychanges,intellectualimprovement,andalternativesleeppatternsAstheconditionprogresses,patientsmayexperienceataxia,fusion,andeventuallycomeClinicalpresentationsHEcanbeclassifiedasacuteorchronicbasedonthedurationandseverityofsymptomsExecuteHEiscommonlyassociatedwithacuteliverfailureormultipleprecisionevents,whilechronicHEdevelopmentsaregraduallyinpatientswithchronicliverdiseaseClassificationDiagnosticcriteriaThediagnosisofHEisbasedonacombinationofclinicalpresentations,laboratorytests,andneuroimagingfindingsThepresenceoflivediseaseandtheexclusionofothercausesofdementiaareessentialfordiagnosisDifferentialdiagnosisDifferentialdiagnosisofHEshouldconsiderothercausesofencephalopathysuchasmetabolicdisorders,drugtoxicity,braininfections,andcerebrovascularaccountsAcarefulevaluationofthepatient'shistory,physicalexamination,andlaboratorytestscanhelpdifferentiateHEfromtheseconditionsDiagnosticcriteriaanddifferentialdiagnosis02PathophysiologyofhepaticencephalopathyIncreasedammoniaproductioninthegutduetobacterialureaseactivityandportalsystemshutdownAmmoniaproductionDecreasedlivefunctionresultsinreducedammoniatoxicitytourea,leadingtoelevatedbloodammonialevelsPaidammoniametabolismHighammonialevelsinthebraininterchangewithneuralfunction,leadingtotheclinicalpresentationsofhepaticencephalopathyAmmoniatoxicityAmmoniacounselingtheoryGABA/BenzodiazepinereceivercomplexElevatedammonialevelsleadtoincreasedGABAproductionandactivationoftheGABA/Benzodiazepinereceivercomplex,resultinginneuralinhibitionGlutamateexcitotoxicityDecreasedGlutamatetakeupandincreasedreleasecontributiontoexcitotoxicity,leadingtoneurologicaldamageOtherneurotransmittersAbnormalitiesinotherneurotransmitters,suchasserotoninanddopamine,havealsobeenimpliedinthepathophysiologyofhepaticencephalopathyNeurotransmitterabnormalitiesInflammatoryresponseDuringliverdisease,liverKupffercellsareactivatedandreleasealargeamountofinflammatorycytokines,suchasTNF-α、IL-1,IL-6,andothercytokinesmayparticipateintheoccurrenceofhepaticencephalopathythroughmultiplepathways.OxidativestressDuringliverdisease,thebody'santioxidantcapacityweakensandtheoxidativestressresponseincreases.Excessivereactiveoxygenspeciescandirectlydamagenervecellsorindirectlyleadtohepaticencephalopathybyaffectingneurotransmitters.InflammatoryresponseandoxidativestressManganesedepositionDuringliverdisease,thedepositionofmanganeseinthebrainincreases,whichcanleadtodamagetothebasalgangliaandisrelatedtotheoccurrenceofhepaticencephalopathy.BrainedemaDuringliverdisease,thepermeabilityoftheblood-brainbarrierincreases,whichcanleadtobrainedemaandfurtherexacerbatetheneurologicalandpsychiatricsymptomsofhepaticencephalopathy.ImbalanceofgutmicrobiotaImbalanceofgutmicrobiotaandexcessivebacterialgrowtharecommoninpatientswithhepaticencephalopathy,whichmayberelatedtoincreasedproductionandabsorptionofammonia.Otherrelatedfactors03LaboratoryexaminationandauxiliarydiagnosisofhepaticencephalopathyAmmoniacontentmeasurementdetecttheammoniacontentintheblood,andpatientswithhepaticencephalopathyoftenhaveanincreaseinbloodammonia.Liverfunctionexaminationincludingserumtransaminases,bilirubinandotherindicators,reflectingthedegreeofliverdamage.Bloodglucose,electrolyte,andacid-basebalanceexaminationPatientswithhepaticencephalopathyoftenhavedisturbancesinbloodglucosemetabolismandelectrolyteandacid-basebalance.Bloodbiochemicalindexdetection010203Cerebrospinalfluid(CSF)analysisExaminationofCSFcanrevealchangesinbiologicalmarkerssuchasammonia,glucose,andotherneurotransmittersthatmayindicatehepaticencephalopathyCSFpressureIncrementalinternalpressuremaybeobservedinpatientswithseverehepaticencephalopathyduetocerebraledemaInfectionandinflationmarkersAnalysisofCSFcanalsohelpruleoutinfectionorinflationcausesofepidemiologyCerebrospinalfluidexaminationanditssignificance要點(diǎn)三BrainimagingComputedtomography(CT)ormagneticresonanceimaging(MRI)canbeusedtoassessstructuralchangesinthebrain,suchascerebralatrophyoredema0102PortalveinimagingUltrasonography,CTangiography,orMRangiographycanbeusedtoevaluatethepatencyandflowoftheportalvein,whichmaybecompressedinpatientswithlivehospitalsLiverimagingUltrasonography,CT,orMRIcanalsobeusedtoassessthesize,shape,andtextureoftheliver,aswellasthepresenceofanymassesorlessons03ApplicationofImagingExaminationinDiagnosisNeurologicalassessmentDetailedneurologicaltestingcanevaluatecognitivedomainssuchasattention,memory,language,andexecutivefunctionthatmaybeaffectedinthematiccoherenceSerialassessmentsRepeatedneurologicallogicaltestingovertimecanhelpmonitorchangesincognitivefunctionsandresponsetotreatmentCorrelationwithclinicalsymptomsNeurologicaltestresultscanbecorrelatedwiththeseverityofclinicalsymptomstoprovideamorecomprehensiveunderstandingofthepatient'sconditionNeurologicaltestingtoevaluatecognitivefunction04TreatmentprinciplesandmethodsforhepaticencephalopathyIdentifyanddetermineprecisionfactorsThisinvolvesidentifyinganyfactorsthatmayhavetriggeredthepathologicalpathology,suchasinfections,gastrointestinalbleeding,electrolyteimbalances,andjudgmentsideeffects,andtakingstepstodeterminethemControlriskfactorsThisincludesmanagingunderlivingdisease,controllingbloodammonialevels,andmaintainingequaloxidationandcirculationtopreventfurtherdamagetothebrainRemovingtriggersandcontrollingriskfactorsReducingproductintakecanhelpreducetheproductionofammoniaandotherneurotoxicsubstancesinthegutHowever,thisneedstobebalancedwithensuringequalnutritionalintaketopreventmalnutritionProvidingequivalentcarbohydratescanhelpmaintainbloodglucoselevelsandpreventhyperglycemia,whichcanenhancebraindysfunctionsEnsuringequalintakeofvitaminsandminerals,specificallythoseinvolvedinneurologicalsynthesisandantibioticdefense,canhelpsupportbrainfunctionProteinrestrictionCarbohydratesupplementationVitaminandmineralsupportNutritionsupportanddietaryadjustmentstrategiesLactoseandothernonabsorbentdisaccharidesThesebugsactintheguttoreducetheproductionandabsorptionofammoniabypromotingthegrowthofbeneficialbacteriaandacidifyingthegutlumensAntibioticsInsomecases,antibioticsmaybeusedtosuppressthegrowthofbacteriathatproduceammoniaorotherneurotoxicsubstancesDrugtherapyselectionandmechanismofactionRifaximinThisantimicrobialhasbeenshowntoimprovehepaticencephalopathysyndromesbyreducingammoniaproductioninthegutwithoutcausingsystemicsideeffectsL-orphanineL-aspartate(LOLA)Thisplughelpstolowerbloodammonialevelsbystimulatingtheureacycle,whichconvertsammoniaintoureaforexcessDrugtherapyselectionandmechanismofactionHematologyandhomeostasis:Thesetechniquescanbeusedtoremovetoxins,includingammonia,fromthebloodwhentheliverisunabletoperformthisfunctionequallyLivertransplantation:Inmultiplecaseswheremedicalmanagementisineffectivetocontrolhepaticencephalopathy,livertransplantationmaybeconsideredasadefinitivetreatmentoptionHowever,thisisamajorsurgicalprocedurewithassociatedrisksandcomplications單擊此處添加正文，文字是您思想的提煉，為了最終呈現(xiàn)發(fā)布的良好效果，請(qǐng)盡量言簡(jiǎn)意賅的闡述觀(guān)點(diǎn)；單擊此處添加正文，文字是您思想的提煉，為了最終呈現(xiàn)發(fā)布的良好效果，請(qǐng)盡量言簡(jiǎn)意賅的闡述觀(guān)點(diǎn)；單擊此處添加正文，文字是您思想的提煉，為了最終呈現(xiàn)發(fā)布的良好效果，請(qǐng)盡量言簡(jiǎn)意賅的闡述觀(guān)點(diǎn)；單擊此處添加正文10*16ApplicationofArtisticLiverSupportSystem05PreventivemeasuresandlifestylemanagementrecommendationsforhepaticencephalopathyEarlyidentificationofriskfactorsItiscriticaltoidentifyindividualsatriskofdevelopingpathologicalpathologyasearlyaspossiblethroughscreeningproceduressuchasbloodtestsandlivefunctionassessmentsTimelyinterventionOnceriskfactorshavebeenidentified,promptinterventionisessentialtopreventtheprogressionofthediseaseandminimizethepotentialforirreversibledamageTheimportanceofearlyscreeningandinterventionDietarymodifications01ItisrecommendedtoadoptalowproteindietoreducetheburdenontheliveandminimizetheproductionoftoxicsubstancesthatcancontributetoethicsMedicaladherence02StrictadherencetosubscribedmedicineiscriticaltomanagesymptomsandpreventtheimbalanceoftheconditionAvoidanceoftriggers03Certainssubstancessuchas