肝性脑病误诊1例报道及文献复习

Misdiagnosis of hepatic encephalopathy:a case report and literature review

探讨肝性脑病(HE)的临床特征及误诊原因。对我科收治的1例HE误诊病例资料进行回顾性分析。本例患者主因乏力伴纳差1年,加重2个月,意识不清约2 h就诊,经过详细询问病史,完善有特征性意义的辅助检查而确诊,因患者病情重、家庭经济条件差,家属放弃治疗。凡以性格改变或行为失常、睡眠障碍等为突出表现的肝病患者,应警惕HE的可能。加强认识、提高诊治水平是尽早确诊、改善预后的关键。

To explore the clinical characteristics and causes of misdiagnosis of hepatic encephalopathy(HE).The data of a misdiagnosed case of HE admitted in our department was retrospectively analyzed.The main cause of going to a doctor of this case was asthenia with poor appetite for one year,aggravation for two months,and unclear consciousness for about two hours.After detailed inquiry of the medical history and improvement of the characteristic auxiliary examination,the diagnosis was made.The family members gave up the treatment because of the patient's serious condition and poor family economic conditions.Liver disease patients with prominent changes in personality or behavioral disorders,sleep disorders,etc.should be alert to the possibility of HE.Strengthening awareness and improving the level of diagnosis and treatment of HE are the keys to early diagnosis and improve prognosis.