摘要
Abstract
Objective To investigate the clinical characteristics,causes of misdiagnosis and preventive measures of hepatic encephalopathy.Methods The clinical data of 8 patients with hepatic encephalopathy who had been misdiagnosed at the initial stage of the disease from April 2020 to November 2022 were analyzed retrospectively.Results All patients had a history of cirrhosis and 4 had a long-term history of alcoholism.There were 4 cases of high protein diet,3 cases of infection and 1 case of diarrhea.There were 5 cases of apathy,confusion in expression,with fluctuating consciousness,and mental and behavioral abnormalities accompanied by aimless repetitive movements,wandering,groping and grasping.At the initial stage of the disease,the liver function test of 2 cases showed mild abnormalities.All 8 cases showed liver cirrhosis with abdominal color Doppler ultrasonography and 5 cases with abdominal fluid.They were misdiagnosed as alcohol withdrawal syndrome in 4 cases,cerebral infarction in 2 cases and schizophrenia in 2 cases.Misdiagnosis lasted 8-10 d.After admission to our hospital,all the 8 patients were diagnosed with hepatic encephalopathy by the examination of menstrual ammonia and liver function,and their condition was relieved after 4-8 days of corresponding treatment.Conclusion Hepatic encephalopathy should be consid-ered in patients with a history of chronic liver disease and neuropsychiatric symptoms.Careful physical examination,detailed medical history and precipitating factors,and early ammonia,liver function and MRI examination are of great importance for the diagnosis of this disease.In order to avoid or reduce misdiagnosis and treatment,hepatic encephalopathy should not be easily excluded in patients with normal liver function or mild abnormalities.关键词
肝性脑病/误诊/乙醇戒断综合征/脑梗死/精神分裂症/血氨/丙氨酸转氨酶/天冬氨酸转氨酶Key words
Hepatic encephalopathy/Misdiagnosis/Alcohol withdrawal syndrome/Cerebral infarction/Schizophre-nia/Blood ammonia/Alanine transaminase/Aspartate transaminase分类
医药卫生
