Sarin S K, Nundy S
Liver. 1985 Jun;5(3):142-6. doi: 10.1111/j.1600-0676.1985.tb00229.x.
Cerebral function was studied in patients with non-cirrhotic portal fibrosis who had no clinically detectable neurological abnormality, 14 before and 29 after a proximal lienorenal shunt operation. In each patient electroencephalography (EEG) and psychometric tests (the number connection test, construction of a five-pointed star and the reverse counting test) were performed. Psychometric tests were also done in an equal number of matched, healthy controls. Subclinical encephalopathy was diagnosed when any of these tests was abnormal. In the unoperated group the EEG was normal in all patients and there was no difference in the psychometric test results between patients and healthy controls. After portosystemic shunt operations, the EEG was abnormal in 10%, the number connection test in 38%, construction of a five-pointed star in 19% and the reverse counting test in 30% of the patients. Detection of subclinical hepatic encephalopathy in such a high proportion of operated patients with non-cirrhotic portal fibrosis suggests that the surgical procedure and its haemodynamic consequences per se could have been responsible.
对无肝硬化性门脉纤维化且无临床可检测到的神经异常的患者进行了脑功能研究，其中14例在近端脾肾分流手术前，29例在手术后。对每位患者进行了脑电图（EEG）和心理测试（数字连接测试、五角星构建和倒数测试）。还对数量相等的匹配健康对照者进行了心理测试。当这些测试中的任何一项异常时，诊断为亚临床脑病。在未手术组中，所有患者的脑电图均正常，患者与健康对照者的心理测试结果无差异。门体分流手术后，10%的患者脑电图异常，38%的患者数字连接测试异常，19%的患者五角星构建异常，30%的患者倒数测试异常。在如此高比例的非肝硬化性门脉纤维化手术患者中检测到亚临床肝性脑病，表明手术操作及其血流动力学后果本身可能是原因。
