肝性脑病--异常门体分流处理的现代观

Hepatic encephalopathy:Modern views on the treatment of abnormal portosystemic shunt

肝性脑病(HE)是由急、慢性肝衰竭或门静脉-体循环分流导致的脑功能障碍,临床表现为神经精神异常。肝硬化患者中HE发生率为16%~21%。自发性门体分流(SPSS)是HE发病的重要机制之一,肝硬化患者中60%~70%存在SPSS,SPSS的大小、数量及部位与HE发生直接相关。影像技术的发展与普及,使SPSS的诊断更加容易和准确。血管介入栓塞SPSS,使部分肝硬化HE患者取得了较好的临床疗效,但仍需要高质量临床研究的支持。

Hepatic encephalopathy(HE)is a type of serious brain dysfunction caused by acute or chronic liver failure or portosystemic shunt,with the clinical manifestation of neuropsychiatric abnormalities.The incidence rate of HE is 16%-21%in patients with liver cirrhosis.Spontaneous portosystemic shunt(SPSS)is one of the major pathogenesis of HE and is observed in 60%-70%of the patients with liver cirrhosis,and the size,number,and location of SPSS are directly associated with the development of HE.The development and wide application of imaging technology help to achieve a more convenient and accurate diagnosis of SPSS.Although interventional vascular embolization of SPSS has achieved a satisfactory clinical outcome in some cirrhotic patients with HE,high-quality clinical studies are still needed.