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肝性脑病(以下简称HE)在内外科领域中不难遇到,属于难治性并发症或综合征之一。晚近由于分子生物学的进展,对其发病机理有了新的认识,治疗上也出现可喜成果。本文仅就这两方面的进展浅述如下。概念与分型HE是1954年Sherlock等人首先明确提出的。后来人们把在各种严重肝损害所致肝功衰竭基础上或因广泛门-腔静脉侧枝循环形成(或其分流术)后出现的,以肝性昏迷为主要特征的神经精神症状统称为HE,即肝脑综合征、肝性昏迷、门-体循环性脑病(PSE)等。
Hepatic encephalopathy (hereinafter referred to as HE) is not difficult to encounter in the field of surgery, is one of the refractory complications or syndromes. Recently, due to the progress of molecular biology, there is a new understanding of its pathogenesis, and gratifying results have also appeared in the treatment. This article only on the progress of these two aspects as follows. The concept and classification HE is Sherlock et al. In 1954 first explicitly proposed. Later, people put on the basis of liver failure caused by severe hepatic impairment, or extensive portal-vena cava collateral circulation (or its shunt), the neuropsychiatric symptoms characterized by hepatic coma are collectively referred to as HE , Namely, liver and brain syndrome, hepatic coma, and portal-circulatory encephalopathy (PSE).