•Definitionofhepaticencephalopathy•Clinicalpresentationsofhepatic•Diagnosisanddifferentialdiagnosisofhepaticencephalopathy•Treatmentandnursingofhepatic•PreventionanddiagnosisofhepaticCHAPTERWhatishepaticencephalopathyHepaticencephalopathy(HE)isaneurologicalconditionthatoccursasaresultoflivefailureorportalsystemshutdownItischaracterizedbyaspectrumofsymptomsrangingfrommillcognitiveimpairmenttocomaHEiscausedbytheaccumulationofammoniaandothertoxinsinthebrain,leadingtoneuroimagingandoxidativestressClassificationofhepaticencephalopathyHEisclassifiedaseitherovertorcoverOverHEismanifestbysymptomssuchasfusion,differentiation,andcoma,whilecoveringHEischaracterizedbysubneopsychiatricchangeslikepersonalitychangesandpsychomotorretentionPathogenesofhepaticencephalopathyPathogenesofhepaticencephalopathy输入02标题010304CHAPTEREarlysymptomsofhepaticencephalopathyMentalstatuschangesMotordysfunctionSleepdisturbancesPaidjudgmentMidtermsyndromesofhepaticencephalopathyProgressivefusionMotorDysfunctionSleepPaidswallowingLatesymptomsofhepaticencephalopathyComaSeveremotordysfunctionDeepunresponsivenesswithnoawarenessofselforenvironmentParallelism,inabilitytomoveanymusclevolleyballBreakingdifficultiesSeveresleepRespiratoryfailureduetomuscleweaknessPersistentdrowsinessleadingtocomaSignsofHepaticEncephalopathyMentalstatuschangesMotorfunctiontestingSleeppatternassessmentNeurologicalexaminationCHAPTERDiagnosticcriteriaforhepaticencephalopathySymptomsLaboratorytestsPhysicalexaminationDifferentialdiagnosisofhepaticencephalopathyMentalIllnessOtherneurologicaldisordersMedicalsideeffectsDiagnosticmethodsforhepaticencephalopathyLiverbiopsyImagingstudiesLaboratorytestsCHAPTERThetreatmentprinciplesofhepaticencephalopathyDrugtherapyforhepaticencephalopathyLactoseLactoseisthemostcommonlyusedbugforthetreatmentofhepaticencephalopathyItactsbydecreasingintestinalammoniaproductionandabsorptionRifaximinRifaximinisabroad-spectrumantimicrobialusedtotreathepaticencephalopathybyreducinggutbacteriaandtheirammoniaproductionOtherdrinksOtherdrinksthatmaybeusedinthetreatmentofhepaticencephalopathyincludingbenzodiazepines,anticonvulsants,andsomeantipsychologyNonpharmacologicaltreatmentofhepaticencephalopathyDietaryLifestylechangesManagementofcomorbiditiesmodificationsAlowproteindiecanhelpreduceammoniaproductionandRegularexercise,smokingprocess,andavoidanceofalcoholandotherheterotopicsubstancescanimprovelivefunctionandreducetheriskofheterotopicepilepsyConditionssuchasdiabetes,hypertension,andhyperlipidemiashouldbewellcontrolledtominimizetheirimpactonliverfunctionandthedevelopmentofhepaticencephalopathyabsorptionInaddition,abalanceddiethatincludessufficientcalories,vitamins,andmineralsisessentialforoverallhealthNursingandrehabitationofhepaticencephalopathyMonitoringPsychosocialsupportRehabilitationClosemonitoringofProvidingemotionalPhysical,occupational,andspeechtherapycanhelppatientsretainlostsupportandeducationtopatientsandtheirfamiliesarecriticaltohelpthemcoverwiththediseaseanditsimpactondailylifepatientswithpathologicalevidenceisessentialtoassesstheirconditionandresponsetotreatmentfunctionsandimprovetheirqualityoflifeCHAPTERPreventivemeasuresforhepaticencephalopathyRegularcheckups01Managementofunderlyinglifedisease02Avoidingtriggers03ThediagnosisofhepaticencephalopathyImprovedwithtreatmentDependentonseverityHighmolalityrateLifeanddietaryrecommendationsforhepaticencephalopathyRegularexerciseBalanceddieAvoidingalcoholMonitoringmentalstatus
