肝硬化并肝性脑病诱因及预后分析

目的：分析肝硬化并肝性脑病的诱因及预后。方法：对94例肝硬化并肝性脑病患者的临床资料回顾性分析。结果：肝性脑病的诱因依此为上消化道出血38例(40．4％)，医源性因素(包括利尿、放腹水、手术、药物)28例(29．8％)，高蛋白饮食11例(11．7％)，感染9例(9．6％)，原因不明6例(6．4％)，便秘2例(2．1％)。各种诱因诱发的肝性脑病病死率：消化道出血21例(48．8％)，医源性因素14例(32．6％)，感染3例(7．0％)，原因不明5例(11．6％)。结论：肝性脑病的预后与诱因是否消除及肝功能状态有关，而消除诱因是治疗肝性脑病的关键。

Analysis of precipitating factors and prognosis for cirrhosis and hepatic encephalopathy

Objective:To analyse the precipitating factors and prgnosis for cirrhosis and hepatic encephalopathy.Methods:The clinical data of 94 patients with cirrhosis and hepatic encephalopathy in this hospital were reviewed.Results:The precipitating factors of hepatic encephalopathy in turn were upper gastrointestinal haemorrhage in 38 patients (40.4%), iatrogenic factors(including operation, diuretic therapy, parcentesis, transfusion and drugs) in 28 patients (29.8%), infection in 9 patients(9.6%), high protein diet in 11 patients(11.7%), unknown reasons in 6 patients(6.4%),constipation in 2 patients (2.1%). The death rate of hepatic encephalopathy caused by various precipitating factors:upper gastrointestinal haemorrhage in 21 patients(48.8%), iatrogenic factors in 14 patients (32.6%), infection in 3 patients(7.0%),unknown reasons in 5 patients(11.6%).Conclusion:The prognosis of hepatic encephalopathy has relation with the eliminating of the precipitating factors and liver function status. Eliminating the precipitating factors is the key to hepatic encephalopathy treatment.