Covert and Overt Hepatic Encephalopathy: Diagnosis and Management.
Covert and Overt Hepatic Encephalopathy: Diagnosis and Management.
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秘密和明显的肝脑病：诊断和管理。
DOI：
10.1016/j.cgh.2015.06.039
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发表时间：
2015-11
期刊：
影响因子：
--
通讯作者：
Bajaj JS
中科院分区：
文献类型：
--
作者：
Patidar KR;Bajaj JS
肝性脑病(HE)是肝硬变患者神经认知改变的一部分。根据严重程度，他被分为两大类，隐性(CHE)和显性(CHE)。胆碱酯酶对患者的生活质量、驾驶表现有重大影响，最近与住院和死亡增加有关。同样，OHE与更高的住院率和死亡率以及较差的生活质量有关。鉴于其对患者、护理人员和卫生保健系统造成的沉重负担，早期诊断和处理势在必行。此外，还应将重点放在患者和家属关于疾病进展和坚持服药的教育上。治疗策略包括使用不可吸收的双糖、抗生素(即利福昔明)和潜在的益生菌。目前正在进一步研究的其他疗法包括：L-鸟氨酸-L-天冬氨酸、鸟氨酸苯乙酸酯、苯丁酸甘油、分子吸附再循环系统和白蛋白输注。
Hepatic encephalopathy (HE) is part of a spectrum of neurocognitive changes in cirrhosis. HE is divided into two broad categories based on severity, covert (CHE) and overt (CHE). CHE has a significant impact on a patient’s quality of life, driving performances, and has recently been associated with increased hospitalizations and death. Likewise, OHE is associated with increased rates of hospitalizations and mortality, and poor quality of life. Given its significant burden on patients, care takers, and the health care system, it’s imperative for early diagnosis and management. In addition, a focus should also be directed on patient and family member education on the disease progression and adherence to medications. Treatment strategies include the use of non-absorbable disaccharides, antibiotics (i.e. rifaximin), and potentially probiotics. Other therapies currently under further investigation include: L-ornithine-L-aspartate, ornithine phenylacetate, glycerol phenylbutyrate, molecular adsorbent recirculating system, and albumin infusion.