Sanchez-Delgado Jordi, Miquel Mireia
Unitat d'Hepatologia, Servei de l'Aparell Digestiu, Hopsital de Sabadell. Corporació Sanitària Parc Taulí. Universitat Autònoma de Barcelona, Sabadell, Barcelona, España; CIBERehd, Instituto de Salud Carlos III, Madrid, España.
Unitat d'Hepatologia, Servei de l'Aparell Digestiu, Hopsital de Sabadell. Corporació Sanitària Parc Taulí. Universitat Autònoma de Barcelona, Sabadell, Barcelona, España; CIBERehd, Instituto de Salud Carlos III, Madrid, España.
Gastroenterol Hepatol. 2016 Apr;39(4):282-92. doi: 10.1016/j.gastrohep.2015.08.003. Epub 2015 Nov 3.
Hepatic encephalopathy (HE) is a frequent and serious complication of liver cirrhosis. In addition to correction of the precipitating factors, the most commonly used treatments are non-absorbable disaccharides and rifaximin. Many of the recommendations are based on current clinical practice and there are few randomized controlled trials. Currently, rifaximin should be initiated during an episode of EH if, after 24-48 hours of non-absorbable disaccharide therapy, there is no clinical improvement. In recurrent EH, it is advisable to add rifaximin in patients under non-absorbable disaccharide therapy who develop a new episode. Currently, standard treatment with rifaximin for minimal EH is not recommended. Rifaximin is effective in the acute treatment of overt encephalopathy and in preventing recurrence.
肝性脑病（HE）是肝硬化常见且严重的并发症。除纠正诱发因素外，最常用的治疗方法是不可吸收的二糖和利福昔明。许多建议基于当前临床实践，随机对照试验较少。目前，如果在不可吸收二糖治疗24 - 48小时后临床症状无改善，应在肝性脑病发作期间开始使用利福昔明。在复发性肝性脑病中，对于接受不可吸收二糖治疗且出现新发作的患者，建议加用利福昔明。目前，不推荐将利福昔明作为轻微肝性脑病的标准治疗。利福昔明在明显脑病的急性治疗和预防复发方面有效。
