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隐匿性肝性脑病诊治目前存在的问题及对策
谭炜,谢渭芬*
0
(第二军医大学长征医院消化内科, 上海 200003
*通信作者)
摘要:
隐匿性肝性脑病定义为有神经心理学和(或)神经生理学异常但无定向力障碍、无扑翼样震颤的肝硬化患者。West-Haven分级标准将肝性脑病分为0~4级,2011年SONIC分级标准将轻微型肝性脑病(0级)和1级肝性脑病合称为隐匿性肝性脑病。隐匿性肝性脑病的临床表现不明显,诊断较为困难,治疗方案尚无统一意见。本文就隐匿性肝性脑病的诊断和治疗进行综述,旨在为临床医师对该病的诊治提供指导。
关键词:  隐匿性肝性脑病  轻微肝性脑病  诊断  治疗  乳果糖  利福昔明
DOI:10.16781/j.0258-879x.2017.09.1119
投稿时间:2017-07-01修订日期:2017-08-25
基金项目:
Problems and countermeasures in diagnosis and treatment of covert hepatic encephalopathy
TAN Wei,XIE Wei-fen*
(Department of Gastroenterology, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China
*Corresponding author)
Abstract:
Covert hepatic encephalopathy (CHE) is defined as presence of neuropsychological and/or neurophysiological abnormalities in cirrhotic patients without disorientation or asterixis. The West-Haven criteria are most often used to grade hepatic encephalopathy (HE), with scores ranging from 0 to 4. In 2011, the minimal (grade 0) and grade 1 hepatic encephalopathy were collectively referred to as CHE by SONIC classification. It is difficult for clinicians to diagnose CHE because its clinical manifestation is not obvious. So far, there is no consensus on CHE treatment. Here we have reviewed the articles regarding the diagnoses and treatment of CHE, hoping to provide guidance for the clinicians in clinical practice.
Key words:  covert hepatic encephalopathy  minimal hepatic encephalopathy  diagnoses  treatment  lactulose  rifaximin