摘要
目的探讨获得性肝脑变性的诊断及治疗方法。方法2021年2—3月于蚌埠市第三人民医院就诊的获得性肝脑变性1例,对其进行病例分析,结合相关文献探讨该病诊断和治疗方法。结果男性,56岁,因“言语不清伴右肢无力1年,加重伴步态不稳半年”入院。既往有肝硬化、脾脏切除术史多年。头颈磁共振可见大脑脚及丘脑区对称性短TI信号影,颈髓内长T2影。血微量元素:全血锰44.1μg/L↑,全血锌3.54 mg/L↓,全血铁241.82μg/L↓。血氨:69μmol/L。诊断为获得性肝脑变性,予以保肝、对症治疗,病人症状好转出院。结论获得性肝脑变性起病隐匿,临床上容易被神经内科医师所忽视,诊断需结合其慢性肝病史、神经系统体征、头颅磁共振特征性表现以及血微量元素测定等综合判定。其治疗目前仍缺乏有效手段,治疗原发病、控制慢性肝病是基础。
Objective To explore the diagnosis and treatment of acquired hepatic and cerebral degeneration.Methods A case of acquired hepatic encephalopathy admitted to the Third People's Hospital of Bengbu from February to March 2021 was analyzed,and the diagnosis and treatment of the disease were discussed combined with relevant literature.Results The patient,male,56 years old,was admitted to the hospital due to"slurred speech accompanied by right limb weakness for 1 year and aggravated walking instability for half a year".He had a history of liver cirrhosis and splenectomy for many years.On head and neck MRI,short TI signal shadows were observed in the brain,foot and thalamus,and long T2 shadows were observed in the cervical medullary area.Blood trace elements:whole blood manganese 44.1μg/L↓,whole blood zinc 3.54 mg/L↓,whole blood iron 241.82μg/L↓.Blood ammonia:69 umol/L.The patient was diagnosed as acquired hepatocerebral degeneration and was given symptomatic treatment to protect the liver.Conclusion Acquired hepatocerebral degeneration has insidious onset and is easily neglected by neurologists in clinic.The diagnosis should be combined with the history of chronic liver disease,the signs of nervous system,the characteristic manifestations of cranial magnetic resonance and the determination of trace elements in blood.At present,there is still a lack of effective means to treat the primary disease and control chronic liver disease.
作者
郭莎莎
苗青
胡林壮
张干
GUO Shasha;MIAO Qing;HU Linzhuang;ZHANG Gan(Department of Neurology,The Third People´s Hospital of Bengbu,Bengbu,Anhui 233000,China)
出处
《安徽医药》
CAS
2023年第4期811-813,共3页
Anhui Medical and Pharmaceutical Journal
关键词
终末期肝病
获得性肝脑变性
肝硬化
基底神经节
锰
锌
铁
诊断
治疗
病例报告
End stage liver disease
Acquired hepatocerebral degeneration
Cirrhosis
Basal ganglia
Manganese
Zinc
Iron
Diagnosis
Treatment
Case reports
