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目的 :探讨重型病毒性肝炎合并肝性脑病与未合并肝性脑病的特点 ,为治疗提供依据。方法 :对比分析 1999年 1月～ 2 0 0 2年 10月我院重型病毒性肝炎合并肝性脑病与未合并肝性脑病的发生率、病死率及与自发性细菌性腹膜炎和上消化道出血及肝肾综合征的关系。结果 :重型病毒性肝炎 2 4 1例中 ,合并肝性脑病 6 8例 (2 8 2 % ) ,与肝性脑病直接相关的死亡 38例 (5 5 9% ) ;同时或先后出现自发性细菌性腹膜炎4 8例 (70 6 % )及上消化道出血 33例 (48 5 % ) ,另外 ,重型病毒性肝炎合并肝性脑病中 ,低血清钾、钠分别为18例 (2 6 5 % )、2 4例 (35 3% )及血氨升高 4 0例 (5 8 8% )。结论 :重型病毒性肝炎合并肝性脑病常与其他并发症共存 ,病死率较高。预防和治疗肝性脑病需要采取综合措施。
Objective: To investigate the characteristics of severe viral hepatitis complicated with hepatic encephalopathy and non-combined hepatic encephalopathy and provide the basis for treatment. Methods: A comparative analysis of January 1999 ~ October 2002 in our hospital severe hepatitis with hepatic encephalopathy and non-associated hepatic encephalopathy incidence, mortality and with spontaneous bacterial peritonitis and upper gastrointestinal bleeding And hepatorenal syndrome. Results: In 2441 cases of severe viral hepatitis, 68 cases (28.2%) had hepatic encephalopathy and 38 cases (55.9%) died of hepatic encephalopathy. Spontaneous bacteria Forty-eight cases (70.6%) had peritonitis and 33 (48.5%) cases had upper gastrointestinal hemorrhage. In addition, 18 patients (26.5%) had low serum potassium and sodium in patients with severe viral hepatitis complicated with hepatic encephalopathy , 24 cases (35 3%) and 40 cases of elevated serum ammonia (588%). Conclusion: Severe viral hepatitis complicated with hepatic encephalopathy often coexist with other complications, with high mortality. Prevention and treatment of hepatic encephalopathy need to take comprehensive measures.