Pantham Ganesh, Mullen Kevin D
Dr Pantham is a clinical instructor of medicine at Case Western University in Cleveland, Ohio, and a hospitalist in the Department of Medicine at the University Hospitals Cleveland Medical Center in Cleveland, Ohio. Dr Mullen is the section chief of digestive diseases and a professor of medicine at the West Virginia University School of Medicine in Morgantown, West Virginia.
Gastroenterol Hepatol (N Y). 2017 Nov;13(11):659-665.
Hepatic encephalopathy (HE) is a condition that encompasses a range of neuropsychiatric abnormalities in patients with significant liver disease. Overt HE occurs in approximately 30% to 45% of patients with cirrhosis. This article discusses practical issues in the management of patients with overt HE and cirrhosis, including a recently developed 4-pronged approach that consists of identifying and correcting precipitating factors, recognizing and treating concomitant medical conditions, commencing empiric treatment, and caring for the unconscious patient. Following recovery from overt HE, a plan of action should be developed to prevent readmissions.
肝性脑病(HE)是一种在患有严重肝脏疾病的患者中出现一系列神经精神异常的病症。显性肝性脑病约发生于30%至45%的肝硬化患者中。本文讨论显性肝性脑病和肝硬化患者管理中的实际问题,包括最近制定的一种四管齐下的方法,该方法包括识别和纠正诱发因素、识别和治疗合并的内科疾病、开始经验性治疗以及护理昏迷患者。显性肝性脑病恢复后,应制定行动计划以防止再次入院。