ĐẶC ĐIỂM LÂM SÀNG VÀ CẬN LÂM SÀNG Ở BỆNH NHÂN XƠ GAN CÓ BIẾN CHỨNG BỆNH NÃO GAN

Abstract

Objective: To investigate clinical and subclinical characteristics in cirrhosis patients with hepatic encephalopathy (HE) complications. Methods: A cross-sectional study was conducted on 92 cirrhotic patients with HE complications. Diagnostic criteria for cirrhosis included hepatocellular insufficiency syndrome and portal hypertension syndrome; chronic liver damage (rough structure, many neoplastic nodules, irregular margins ...) in abdominal ultrasound or CT scan. Criteria for diagnosis of clinical HE included cognitive disorders, sleep disturbances, personality changes, behavioral changes, impaired consciousness, speech, and trembling marks with exclusion of other causes of psychosis. Results: The mean age of patienst was 55.5 years old, the male/female ratio was 2.7: 1. Perceptual disturbances (47.8%) and gastrointestinal bleeding (23.9%) were the main causes of hospitalization. Stage III of HE accounted for the majority with the rate of 62.0%; followed by stage IV with a rate of 30.4%. Hemoglobin, platelet and serum albumin levels decreased in most patients, 77.2%, 89.1% and 96.7%, respectively. Increased blood NH₃ was predominant in all three HE levels. Conclusion: Stage III of HE accounted for the majority and often presented with many symptoms at the same time. Care should be taken to screen for decreased hemoglobin, decreased platelet count, decreased serum albumin, prolonged PT and increased bilirubin to prognosis of advanced cirrhosis. In addition, signs of increased NH₃ should be considered in patients with HE of all stages.