Walter E
Departement für Innere Medizin, Universitätsspital Zürich.
Schweiz Med Wochenschr. 1994 Jul 2;124(26):1147-54.
The term "hepatic encephalopathy" describes the neuropsychiatric signs and symptoms of patients with acute or chronic liver disease, irrespective of the presence or absence of liver cirrhosis. Cerebral edema, the pathophysiology and treatment of which being quite different from hepatic encephalopathy, is the leading cause of death in patients with acute liver failure. Lactulose (orally or as enema) is one of the cornerstones of the treatment of hepatic encephalopathy; most important for the management of patients with cerebral edema is close monitoring (including intracranial pressure monitoring) of the patients and rapid reduction of intracranial pressure (e.g. with mannitol). The pathophysiologic and therapeutic concepts in the care of patients with hepatic encephalopathy and cerebral edema are described.
术语“肝性脑病”描述了急性或慢性肝病患者的神经精神体征和症状，无论是否存在肝硬化。脑水肿的病理生理学和治疗方法与肝性脑病截然不同，它是急性肝衰竭患者的主要死亡原因。乳果糖（口服或灌肠）是肝性脑病治疗的基石之一；对于脑水肿患者的管理，最重要的是密切监测患者（包括颅内压监测）并迅速降低颅内压（如使用甘露醇）。本文描述了肝性脑病和脑水肿患者护理中的病理生理和治疗概念。
