摘要
肝硬化患者失代偿期常发生神经系统并发症,发病原因有多种,可以发生于肝移植术前、术中或术后。本研究的目的是阐述肝硬化失代偿期、肝移植术后中枢神经系统并发症,评价肝硬化、肝移植后神经系统的并发症。一些相关毒素如血氨、锰、苯二氮类物质、γ-氨基丁酸样物质及受损的多巴胺能神经传导通路等在肝移植术前的肝性脑病、亚临床肝性脑病的病因中起重要作用。肝移植术后常见并发症有脑桥中央髓鞘溶解症、脑血管自身调节障碍和脑动脉栓塞。这些并发症的发生有多种发病机制,如移植肝脏功能衰竭、颅内出血、脑梗死和感染,或免疫抑制剂的毒性作用。
Neurological complications are common in cirrhotic patients with end-stage liver failure. They comprise a wide array of etiologies, which may originate before, during, or after liver transplantation. The objective of this study was to describe and evaluate the nature of the neurological complications in patients with end-stage liver failure and after liver transplantation. Several toxins including ammonia, manganese, benzodiazepine - like substances, gamma- aminobutyric acid-like substances, and impaired dopaminergic neurotransmission are at the top of the list of candidates for hepatic encephalopathy, subclinical encephalopathy, and extrapyramidal signs before liver transplantation. Central pontine myelinolysis, cerebrovascular autoregulation impairment, and paradoxical cerebral embolism are probably responsible for the neurological complications during liver transplantation. These complications have been attributed to several pathogenetic factors, such as a poorly functioning graft, an intracranial hemorrhage, a cerebral infarction, an infection, or the toxicity of immunosuppressants.
出处
《中国医学计算机成像杂志》
CSCD
2008年第6期465-471,共7页
Chinese Computed Medical Imaging
关键词
急性肝衰竭
肝硬化
肝移植
神经系统
影像
Acute liver failure
Liver cirrhosis
Liver transplant
Neurological complications
Imaging
