肝性脑病治疗措施的研究进展

Research Progress on Treatment Measures for Hepatic Encephalopathy

摘要: 肝性脑病是由严重肝功能障碍或门体分流引起的神经精神异常综合征，其治疗强调多靶点、系统性管理。核心策略包括识别并去除诱因(如感染、消化道出血)、降低血氨(使用乳果糖、利福昔明等药物)、营养支持与蛋白质合理摄入、调节肠道微生态(如益生菌、粪菌移植)以及中医中药辅助治疗。对于重症患者，人工肝支持系统和肝移植是重要的救治手段。长期管理则注重一级与二级预防，结合定期监测与健康教育，以控制复发并改善患者生活质量。未来，针对肝–肠–脑轴的深入研究有望推动肝性脑病治疗策略的进一步优化。

Abstract: Hepatic encephalopathy is a neuropsychiatric syndrome caused by severe liver dysfunction or portosystemic shunting. Its treatment emphasizes multi-target and systematic management. The core strategies include identifying and removing inducing factors (such as infection and gastrointestinal bleeding), reducing blood ammonia (using drugs like lactulose and rifaximin), providing nutritional support and ensuring reasonable protein intake, regulating the gut microbiota (such as using probiotics and fecal microbiota transplantation), and using traditional Chinese medicine as adjunctive therapy. For critically ill patients, artificial liver support systems and liver transplantation are important treatment measures. Long-term management focuses on primary and secondary prevention, combined with regular monitoring and health education to control recurrence and improve the quality of life of patients. In the future, in-depth research on the liver-gut-brain axis is expected to promote further optimization of the treatment strategies for hepatic encephalopathy.