文章摘要
郭莎莎.获得性肝脑变性1例报道[J].安徽医药,待发表.
获得性肝脑变性1例报道
投稿时间:2021-11-30  录用日期:2022-01-10
DOI:
中文关键词: 获得性肝脑变性  肝硬化  诊断  治疗  病例报道
英文关键词: 
基金项目:
作者单位邮编
郭莎莎 蚌埠市第三人民医院 233000
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中文摘要:
      目的:通过1例获得性肝脑变性的病例分析,探讨该病的诊断及治疗方法。 方法:分析病例结合相关文献探讨诊断和治疗方法。 结果:患者男性,56岁,因“言语不清伴右肢无力1年,加重伴行走不稳半年”收住入院。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44.1ug/L↑,全血锌3.54mg/L↓,全血铁241.82ug/L↓。血氨:69umol/L。诊断为获得性肝脑变性,予以保肝、对症治疗,患者症状好转出院。 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。有关其治疗目前也仍缺乏有效手段,治疗原发病、控制慢性肝病是基础。
英文摘要:
      Objective To explore the diagnosis and treatment of acquired hepatic and cerebral degeneration by analyzing a case. Methods To explore the diagnosis and treatment of cases combining with relevant literatures. Results A 56-year-old male patient was admitted to hospital due to "slurred speech accompanied by right limb weakness for 1 year and aggravated walking instability for 6 months".He had a history of liver cirrhosis and splenectomy for many years. On head and neck MRI, symmetrical short TI signal shadows were observed in cerebral peduncle and thalamus, and long T2 shadows were observed in the cervical medullary area. Blood trace elements: whole blood manganese 44.1ug/L ↓, whole blood zinc 3.54mg/L↓, whole blood iron 241.82ug/L↓. Blood ammonia: 69umol/L. The patient was diagnosed as acquired hepatocerebral degeneration and was given symptomatic treatment to protect the liver.Eventually, the patient was discharged as his symptoms improved. 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. There is currently no effective treatment for the disease,and the key of treatment is the control of primary chronic liver disease.
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