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肝昏迷戒称肝性脑病(Hepatic encephalopathy)。肝昏迷是肝功能衰竭的终末期。肝功能衰竭分为急性和慢性肝功能衰竭。前者多见于暴发型肝炎,后者多见于肝硬化及肝癌。不论前者后者肝昏迷是共同的结局,治疗方法基本一致。 治疗原则 1.积极治疗原发性疾病 如重症肝炎、肝硬化、肝癌等。 2.清除诱发因素 如控制感染、停止放腹水、纠正水电解质紊乱、抗休克等。 3.无特效治疗,故采用综合治疗。 治疗方案 1.防治氨中毒 目前认为是首要环节。对血氨增高的患者有一定疗效。 (1)减少氨的吸收,增加氨的排除
Hepatic encephalopathy is called hepatic coma. Hepatic coma is the terminal stage of liver failure. Liver failure is divided into acute and chronic liver failure. The former is more common in fulminant hepatitis, which is more common in cirrhosis and liver cancer. Regardless of the former hepatic coma is the common outcome, the treatment is basically the same. Treatment principles 1. Active treatment of primary diseases such as severe hepatitis, cirrhosis, liver cancer. 2. Clear the trigger factors such as infection control, stop ascites, water and electrolyte disorders, anti-shock and so on. 3. No special treatment, so the use of comprehensive treatment. Treatment options 1. Ammonia poisoning is currently considered to be the primary link. Ammonia increased in patients with a certain effect. (1) reduce the absorption of ammonia, increase the elimination of ammonia