肝脏脑病在经内肝脏系统内港口位放置后发生的肝脏脑病
1Department of Radiology, Section of Interventional Radiology, Northwestern Memorial Hospital, Chicago, Illinois.
Seminars in interventional radiology
|July 24, 2023
概括
肝脑病 (HE) 是一种影响精神状态的肝病并发症. 治疗包括乳和利法西明,在TIPS安置后对耐火病例进行分流调整.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 神经学 神经学
- 胃肠病学 胃肠病学
背景情况:
- 肝发性脑病 (HE) 是慢性肝病和移植系统位的复杂的神经并发症.
- 病理生理学涉及氨的代谢,炎症和肉症.
- 症状范围从亚临床到昏迷,按西黑文分类进行分级.
研究的目的:
- 审查肝脏脑病理学,诊断和肝脏脑病变的管理.
- 为了突出HE作为一个并发症的跨内肝移植系统分流 (TIPS) 放置.
- 讨论HE的治疗策略,包括医疗和程序干预.
主要方法:
- 关于HE病理生理学,临床表现和治疗的文献综述.
- 分析与TIPS程序相关的HE风险.
- 治疗选择的评估,包括乳糖,利法西明和分流修饰.
主要成果:
- 它涉及氨代谢受损,炎症和萨尔科佩尼亚.
- TIPS安置可以增加HE的风险,尽管新的支架可以减轻这一点.
- 乳糖和利法西明是主要的治疗方法;对于TIPS后的耐火性HE,可能需要减少或关闭分流.
结论:
- 肝脑病需要彻底的差分诊断和适当的管理.
- 在TIPS程序之前,对HE风险的患者咨询至关重要.
- 应量身定制管理策略,考虑医疗治疗和潜在的分流干预措施.
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