中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R

留言板

尊敬的读者、作者、审稿人, 关于本刊的投稿、审稿、编辑和出版的任何问题, 您可以本页添加留言。我们将尽快给您答复。谢谢您的支持!

姓名
邮箱
手机号码
标题
留言内容
验证码

轻微肝性脑病的治疗现状

赵凯 张跃新

引用本文:
Citation:

轻微肝性脑病的治疗现状

DOI: 10.3969/j.issn.1001-5256.2014.10.030
详细信息
  • 中图分类号: R747.9

Treatment of minimal hepatic encephalopathy

  • 摘要: 轻微肝性脑病(MHE)是肝性脑病发病的起始阶段,无明显的临床表现,但是对患者的日常生活安全产生了严重的影响,在现代医学中受到越来越多的重视,治疗方法主要包括去除诱因和药物治疗两个部分。介绍了轻微肝性脑病的相关治疗,并对各种治疗方案的疗效进行了客观评价。认为现治疗方案主要是多种治疗方法的联合应用,但没有试验证明联合应用可提高疗效。

     

  • [1]DHIMAN RK, SARASWAT VA, SHARMA BK, et al.Minimal hepatic encephalopathy:consensus statement of a working part of the Indian National Association for Study of the Liver[J].J Gastroenterol Hepatol, 2010, 25 (6) :1029-1041.
    [2]LI SW, XU JM, HU KF, et al.Prevalence of minimal hepatic encephalopathy and analysis of associated risk factors[J].Chin J Gastroenterol Hepatol, 2012, 21 (2) :176-179. (in Chinese) 李素文, 许建明, 胡凯风, 等.轻微肝性脑病患病情况调查及相关危险因素分析[J].胃肠病学和肝病学杂志, 2012, 21 (2) :176-179.
    [3]LIN Y, FAN YP.The neuropsychologic tests and the minimal hepatic encephalopathy investigations in liver cirrhotic patients[J].Chin J Hepatol, 2011, 19 (1) :65-66. (in Chinese) 林言, 范燕萍.肝硬化患者的神经心理测验及轻微肝性脑病调查[J].中华肝脏病杂志, 2011, 19 (1) :65-66.
    [4]ZHAN T, STREMMEL W.The diagnosis and treatment of minimal hepatic encephalopathy[J].Dtsch Arztebl Int, 2012, 109 (10) :180-187.
    [5]MONTGOMERY JY, BAJAJ JS.Advances in the evaluation and management of minimal hepatic encephalopathy[J].Curr Gastroenterol Rep, 2011, 13 (1) :26-33.
    [6]MULLWN KD, PRAKASH RK.Management of covert hepatic encephalopathy[J].Clin Liver Dis, 2012, 16 (1) :91-93.
    [7]BAJAJ JS, SAEIAN K, SCHUBERT CM, et al.Minimal hepatic encephalopathy is associated with motor vehicle crashes:the reality beyond the driving test[J].Hepatology, 2009, 50 (4) :1175-1183.
    [8]BAJAJ JS, HEUMAN DM, WADE JB, et al.Rifaximin improves driving simulator performance in a randomizes trial of patients with minimal hepatic encephalopathy[J].Gastroenterology, 2011, 140 (2) :478-487.
    [9]PRAKASH R, MULLEN KD.Mechanisms, diagnosis and management of hepatic encephalopathy[J].Nat Rev Gastroenterol Hepatol, 2010, 7 (9) :515-525.
    [10]WEN J, LIU Q, SONG J, et al.Lactulose is highly potential in prophylaxis of hepatic encephalopathy in patients with cirrhosis and upper gastrointestinal bleeding:results of a controlled randomized trial[J].Digestion, 2013, 87 (2) :132-138.
    [11]MITTAL VV, SHARMA BC, SHARMA P, et al.A randomized controlled trial comparing lactulose, probiotics, and L-ornithine L-aspartate in treatment of minimal hepatic encephalopathy[J].Eur J Gastroenterol Hepatol, 2011, 23 (8) :725-732.
    [12]BAJAJ JS, HEUMAN DM, SANYAL AJ, et al.Modulation of the metabiome by rifaximin in patients with cirrhosis and minimal hepatic encephalopathy[J].PLoS One, 2013, 8 (4) :e60042.
    [13]SIDHU SS, GOYAL O, MISHRA BP, et al.Rifaximin improves psychometric performance and health-related quality of life in patients with minimal hepatic encephalopathy (the RIME Trial) [J].Am J Gastroenterol, 2011, 106 (2) :307-316.
    [14]SAJI S, KUMAR S, THOMAS V.A randomized double blind placebo controlled trial of probiotics in minimal hepatic encephalopathy[J].Trop Gastroenterol, 2011, 32 (2) :128-132.
    [15]SHARMA P, SHARMA BC, PURI V.An open-label randomized controlled trial of lactuloseand probiotics in the treatment of minimal hepatic encephalopathy[J].Eur J Gastroenterol Hepatol, 2008, 20 (6) :506-511.
    [16]SHUKLA S, SHUKLA A, MEHBOOB S, et al.Meta-analysis:the effects of gut flora modulationusing prebiotics, probiotics and synbiotics on minimal hepatic encephalopathy[J].Aliment Pharmacol Ther, 2011, 33 (6) :662-671.
    [17]LES I, DOVAL E, GARCIA-MARTINEZ R, et al.Effects of branched-chain amino acids supplementation in patients with cirrhosis and a previous episode of hepatic encephalopathy:a randomized study[J].Am J Gastroenterol, 2011, 106 (6) :1081-1088.
    [18]BAI M, YANG Z, QI X, et al.l-ornithine-l-aspartate for hepatic encephalopathy in patients with cirrhosis:a meta-analysis of randomized controlled trials[J].J Gastroenterol Hepatol, 2013, 28 (5) :783-792.
    [19]KATO A, TANAKA H, KAWAGUCHI T, et al.Nutritional management contributes to improvement in minimal hepatic encephalopathy and quality of life in patients with liver cirrhosis:A preliminary, prospective, open-label study[J].Hepatol Res, 2013, 43 (5) :452-458.
    [20]VAISMAN N, KATZMAN H, CARMIEL-HAGGAI M, et al.Breakfast improves cognitive function in cirrhotic patients with cognitive impairment[J].Am J Clin Nutr, 2010, 92 (1) :137-140.
  • 加载中
计量
  • 文章访问数:  2606
  • HTML全文浏览量:  10
  • PDF下载量:  620
  • 被引次数: 0
出版历程
  • 收稿日期:  2013-12-26
  • 出版日期:  2014-10-20
  • 分享
  • 用微信扫码二维码

    分享至好友和朋友圈

目录

    /

    返回文章
    返回