Методические руководства кафедры / Гастроэнтерология / ХГ и ЦП (Бельтюков)
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печени
Вслучае тяжелой печеночной энцефалопатии.
Вслучае молниеносная печеночная
недостаточность.
• GI bleeding |
• Tissue bleeding |
• Protein overload |
• Muscle wasting |
• Constipation |
• Catabolism |
• Intestinal infection |
• Renal azotemia |
|
• Extraintestinal |
|
infections, sepsis |
Increased intestinal |
Increased extraintest. |
ammonia |
ammonia |
production |
production |
|
HYPERAMMONIEMIA |
|
• Bowel cleaning |
• Hemostasis |
|
• Hemostasis |
• Reduction of physical |
|
• Lactulose |
load |
|
• Antibiotics |
||
• Protein restriction |
||
• Diuretics reduction |
||
• Antibiotics |
||
• Lactulose |
||
|
||
|
• Ornithine-aspartate |
•Critical decrease of hepatocytes amount
•Portocaval anastomosis
•Acidosis
•Diuretics
•Massive laparocentesis
Reduced ammonia detoxification
•Treatment of the main disease
•Lactulose
•Ornithine-aspartate
•Benzoate
•Diuretics reduction
1994 Conn, .O.H
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