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Journal of the Korean Academy of Family Medicine 1991;12(8):58-64.
Published online August 1, 1991.
Clinical observations of hepatic encephalopathy.
Sung In Hong, Ki Pyo Hong, Sang Hwa Lee
간성 뇌증에 대한 임상적 고찰
홍성인, 홍기표, 이상화
서울기독병원 가정의학과
Abstract
Hepatic encephalopathy ocurring in patients with acute and chronic liver disease is considered lethal if not treated appropriately, but can be entirely reversible.
In addition, liver cirrhosis and hepatoma are considered serious problems due to high prevalence of type B hepatitis in Korea.
Forty-six cases of hepatic encephalopathy, admitted in Seoul Christian Hospital from Mar. 1989 to Feb. 1990, were analyzed retrospectively.
The results of this study were as follows :
1. Men were 37 cases(80.4%) and women were 9 cases(19.6%), and the male to female ratio was 4.1:1
2. The mean age of the patients was 48.7 years old and 23 cases(50.0%) were in 5th decade, 12 cases(10.9%) in 6th decade, and 5 cases(10.95) in 4th and 7th decade, respectively.
3. Underlying liver disease were 39 cases(84.8%) of liver cirrhosis, 5 cases(10.9%) of type B hepatitis, and each 1 case(2.2%) of hepatoma and metastatic liver carcinoma.
4. Precipitating factors were gastrointestinal hemorrhage in 15 cases(32.6%), infection in 10 cases(21.7%), paracentesis in 6 cases(13.0%), constipation in 3 cases(6.5%), hyponatremia in 2 cases(4.3%), and hypokalemia in 1 case(2.2%).
5. Neuropsychiatric features were mental change in 28 cases(60.9%), flapping tremor in 12 cases(26.0%), irritability in 3 cases(6.5%), and seizure in 2 cases(4.3%).
6. The level of SGOT and SGPT was increased in 42 cases(93.3%), and its mean value was 175.9I U/L and 104.3 IU/L.
7. The level of Serum ammonia was increased in 43 cases(93.4%), and its mean value was 238.4.
8. 19 cases(41.3%) were expired, 21 cases(45.7%) were recovered and 6 cases(13.0%) were discharged against advice.


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