Hepatik Ensefalopati Tip C Hastalarında Tetikleyici Faktörler ve Kliniko-Endoskopik Çalışma

Year 2022, Volume: 12 Issue: 4, 559 - 564, 31.07.2022

Harshal Khobragade Tanuja Manohar Amol Sathawane

https://doi.org/10.16899/jcm.979964

Abstract

Giriş: Hepatik ensefalopati (HE), ağır karaciğer hastalığı ve vücuttan toksinleri atmakta yetersiz kalması sonucu beyin fonksiyonlarında azalmadır. Kişilik değişiklikleri, zihinsel bozulma ve bilinç kaybı ile karakterizedir. Bu çalışma, karaciğer sirozu olan hastalarda hepatik ensefalopatinin tetikleyici faktörlerini ve endoskopik özelliklerini belirlemek ve Orta Hindistan'da üçüncü basamak bir hastaneye kabul edilen ilişkili klinik özellikleri değerlendirmek için yapılmıştır.

Gereç ve Yöntem: Bu hastane bazlı tanımlayıcı kesitsel çalışma, Kasım 2016 ile Ekim 2018 tarihleri arasında, 18 yaş üstü hepatik ensefalopati tip C'li 102 hasta üzerinde yürütülmüştür. tasarlanmış proforma Kategorik sonuçların çalışma grupları arasında Ki kare testi/Fisher's Exact testi kullanılarak karşılaştırıldığı istatistiksel analiz için gönderildiler.

Bulgular: Çalışmamızda HE prevalansı %19,6 idi. Bu çalışmada HE için önde gelen presipitanlar arasında kabızlık (%26,5), elektrolit dengesizliği (%21,6), böbrek yetmezliği (%18,6) ve üst gastrointestinal kanama (%18,6) olduğunu gözlemledik. Karaciğer yetmezliğinin yanı sıra, pıhtılaşma anormallikleri, böbrek düzensizliği ve serum sodyum seviyelerindeki değişiklikler gibi çeşitli faktörlerdeki ilişkili anormallikler, HE'nin daha yüksek derecelere ilerlemesine neden olabilir.

Sonuç: Siroz seyrinde kabızlık, elektrolit dengesizliği, böbrek yetmezliği ve üst GİS kanaması gibi farklı faktörlerin HE gelişimini önlemeye yardımcı olması için erken dönemde belirlenmesi önemlidir.

Keywords

Beyin, siroz, hepatik ensefalopati, karaciğer, kolaylaştıran faktörler

Precipitating Factors and Clinico-Endoscopic Study of Patients with Hepatic Encephalopathy Type C

Abstract

Introduction: Hepatic encephalopathy (HE) is a decline in brain function as a result of severe liver disease and its inadequacy to remove toxins from the body. It is characterized by personality changes, intellectual impairment, and loss of consciousness. This study was conducted to determine the precipitating factors and endoscopic features of hepatic encephalopathy in patients with liver cirrhosis and evaluate the associated clinical features admitted in a tertiary hospital in Central India.
Materials and Methods: This hospital-based descriptive cross-sectional study was conducted from November 2016 to October 2018 on 102 patients with hepatic encephalopathy type C, aged above 18. All patients were carefully examined, relevant investigations performed, and data collected through pre-designed proforma. They were sent for statistical analysis where categorical outcomes were compared between study groups using the Chi-square test /Fisher's Exact test.
Results: The prevalence of HE was 19.6% in our study. In this study, we observed that constipation (26.5%), electrolyte imbalance (21.6%), renal failure (18.6%), and upper GI bleeding (18.6%) be among the leading precipitants for HE. Besides liver failure, the associated abnormalities in various factors like coagulation abnormalities, renal derangement, and changes in serum sodium levels can lead to the progression of HE to higher grades.
Conclusion: It is essential to identify the different factors like constipation, electrolyte imbalance, renal failure, and upper GI bleeding early in the course of cirrhosis to help prevent the development of HE.

Keywords

Brain, Cirrhosis, Hepatic Encephalopathy, Liver, Precipitating Factors

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