肝性脑病英文教案课件.pptx
- 【下载声明】
1. 本站全部试题类文档,若标题没写含答案,则无答案;标题注明含答案的文档,主观题也可能无答案。请谨慎下单,一旦售出,不予退换。
2. 本站全部PPT文档均不含视频和音频,PPT中出现的音频或视频标识(或文字)仅表示流程,实际无音频或视频文件。请谨慎下单,一旦售出,不予退换。
3. 本页资料《肝性脑病英文教案课件.pptx》由用户(晟晟文业)主动上传,其收益全归该用户。163文库仅提供信息存储空间,仅对该用户上传内容的表现方式做保护处理,对上传内容本身不做任何修改或编辑。 若此文所含内容侵犯了您的版权或隐私,请立即通知163文库(点击联系客服),我们立即给予删除!
4. 请根据预览情况,自愿下载本文。本站不保证下载资源的准确性、安全性和完整性, 同时也不承担用户因使用这些下载资源对自己和他人造成任何形式的伤害或损失。
5. 本站所有资源如无特殊说明,都需要本地电脑安装OFFICE2007及以上版本和PDF阅读器,压缩文件请下载最新的WinRAR软件解压。
- 配套讲稿:
如PPT文件的首页显示word图标,表示该PPT已包含配套word讲稿。双击word图标可打开word文档。
- 特殊限制:
部分文档作品中含有的国旗、国徽等图片,仅作为作品整体效果示例展示,禁止商用。设计者仅对作品中独创性部分享有著作权。
- 关 键 词:
- 肝性脑病 英文 教案 课件
- 资源描述:
-
1、1肝性脑病英文肝性脑病英文第第1页页/共共68页页2nIntroduction and ConceptionnEtiologynHepatic insufficiencynHepatic failure Hepatic encephalopathy(focal point)Hepatorenal syndromeHepatic Failure第第2页页/共共68页页3PART I Introduction and ConceptionLiverThe largest and most metabolically complex organ1.The liver第第3页页/共共68页页42.Th
2、e liver anatomyThe liver is divided into 2 main lobes,each consisting of many lobules.These lobules are surrounded by branches of the hepatic artery,which supplies the liver with oxygenated blood.The portal vein supplies nutrient-rich blood.Deoxygenated blood from the liver drains into the hepatic v
3、eins.A network of ducts carries bile from the liver to the gallbladder and the small intestine第第4页页/共共68页页53.The functions of the liver Substance metabolism immune function Hemostasis regulation production and secretion of bile Bio-transformation(detoxification)第第5页页/共共68页页64.Hepatic insufficiencySe
4、vere damage in liver cells will result in serious condition,manifesting as jaundice,bleeding,infection,renal dysfunction or encephalopathy,termed all together these syndromes of hepatic insufficiency.Acute Hepatic insufficiency Chronic Hepatic insufficiency 第第6页页/共共68页页75.Hepatic failureTerminal sta
5、ge of hepatic insufficiencyHepatic encephalopathy(focal point)Hepatorenal syndromePrimary clinical manifestations第第7页页/共共68页页8PART II Etiology1.Biological2.Physical and chemical 3.Inherited conditions 4.Immune 5.Nutritional causesHepatitis virus(such as HBV),bacteria,parasites,etc.Industrial toxins,
6、some drugs,alcohol,etc.Idiopathic hemochromatosis,Wilsons disease,etc.Extent of inflammation and necrosis 第第8页页/共共68页页9PART III Hepatic insufficiencyLiverVarious etiology causeshepatocytesNon-parenchymalcellsdamagedamage Kupffer cells,hepatic satellite cells,lipocytes,liver associated lymphocytes,he
7、patic sinusoid endothelial cellsHepatic insufficiency第第9页页/共共68页页10Syndromes of Hepatic insufficiency1.Metabolic disorders2.Water and electrolytes imbalance3.Disorders in production of bile salts and elimination of bilirubin4.Impaired kupffer cells functionCarbohydrate Metabolic DisordersLipid Metab
8、olic DisordersProtein Metabolic DisordersHepatic AscitesElectrolytic Metabolic Disorders第第10页页/共共68页页111.Metabolic disorders1)Carbohydrate Metabolic DisordersCarbohydrate Metabolism of liverTo maintain concentrations of glucose in blood within a narrow,normal range.insulinA hormone produced by the p
9、ancreas that regulates glucose levels in the blood.It is normally produced in response to raised glucose levels following a meal and promotes glucose absorption into the liver and muscle cells(where it is converted into energy).Excess glucose entering the blood after a meal is rapidly taken up by th
10、e liver and sequestered as the large polymer,glycogenglycogenesis第第11页页/共共68页页12glyconeogenesisglycogenolysiswhen blood concentrations of glucose begin to decline,the liver activates other pathways which lead to depolymerization of glycogenWhen hepatic glycogen reserves become exhaused,as occurs whe
11、n an animal has not eaten for several hours,the hepatocytes,recognize the problem and activate additional groups of enzymes that begin synthesizing glucose out of such things as amino acids and non-hexose carbohydrates.第第12页页/共共68页页13Severe liver diseaseHypoglycemiaHyperglycemiaCaused by a decrease
12、in functional hepatocyte mass.When glucogen reserves are depleted:gluconeogenensis impared;inactivation of insulin weakenCaused by portal-to-systemic shuntingDecrease the postprandial extraction of glucose from protal bloodSome patients may suffer abnormal glucose tolerance第第13页页/共共68页页141.Metabolic
13、 disorders2)Lipid Metabolic DisordersLiver is the center of lipid metabolismManufacturing 80%of the cholesterolSynthesizing,storing and exporting triglyceridesAssembling,secreting and taking up lipoprotein particle,such as VLDL,LDL,and HDL.第第14页页/共共68页页Severe liver diseaseDisturbance of lipid metabo
14、lismSyndromes of fat accumulation(fatty liver)In certain chronic liver diseasePrimary biliary cirrhosisDestruction of bile ductsBile flow decreaseDecrease lipid clearance via bilehyperlipidemiaThese patients often develop xanthomas accumulation of cholesterol 第第15页页/共共68页页161.Metabolic disorders3)Pr
15、otein Metabolic DisordersThe liver manufactures and secretes many of the protein found in plasmaalbuminSome clotting factorsSome binding proteinsSome hormone precursorsTo maintain plasma oncotic pressureTo regulate hemostasisSteroid and thyroid hormone-binding protein to regulate metabolismangiotens
16、inogen to regulate blood pressureInsulin like growth factor-1 to regulate growth第第16页页/共共68页页17Other roles of the liver in protein metabolismProcesses of oxidative deamination and transaminationThe urea cycle allows nitrogen to be excreted in the form of urea第第17页页/共共68页页Severe liver diseaseDisturba
17、nce of protein metabolismDecreased conversion of ammonia to ureaPlasma proteins decreaseElevated ammonia levelalbuminClotting factorsHepatic encephalopathyEdema and ascitesBleeding tendancy第第18页页/共共68页页192.Water and electrolytes imbalance1)Hepatic AscitesAscties is the presence of the excess fluid i
18、n the peritoneal cavityIt is a late-staged manifestation of the liver disease.第第19页页/共共68页页20Mechanisms of Hepatic Ascites1)An increase in capillary pressureCauses:portal hypertension;obstruction of venous and lymph flow 2)Decrease in colloidal osmotic pressureCause:impaired synthesis of albumin3)Sa
19、lt and water retention by the kidneyCause:effective blood volume is reduced because of fluid shift and vasodilation glomerular filtration rate(GFR)rennin-angiotension-aldosterone system(+)metabolism of aldosterone portal-to-systemic shunting vasodilatory products are dilvered to the systemic circula
20、tion 第第20页页/共共68页页212.Water and electrolytes imbalance2)Electrolytic Metabolic Disorders1)Hypokalemia2)Hyponatremia第第21页页/共共68页页223.Disorders in production of bile salts and Elimination of bilirubinSevere liver diseaseA failure to secrete bileA Failure to solubilize substancesMalabsorption and defic
21、iency statesDecreased elimination of bilirubinElevation of serum bilirubin and jaundiceJaundice:Yellowing of the skin and the whites of the eyes,caused by an accumulation of bilirubin in the blood.第第22页页/共共68页页234.Impaired kupffer cells functionKupffer cells function1)Removing and phagocytizing old
22、and defective blood cells,bacteria,etc.2)Producing a variety of bioactive substances and cytokines,such as IL-1,IL-6 etc.第第23页页/共共68页页24dysfunction of Kupffer cellsLoss of clearance function to bacteriaPortal-systemic shuntingEnteric toxins enter the systemic circulationEnteric endotoxemia第第24页页/共共6
23、8页页25BriefSymptoms of hepatic failureWater and electrolytesimbalanceHypo or hyper-glycemiaHyperlipidemia and xanthomasPlasma proteins decrease edema,bleedingMetabolic disordersHepatic AscitesHypokalemia and HyponatremiaDisorders in production of bile saltsand Elimination of bilirubinMalabsorption an
24、d deficiency statesElevation of serum bilirubin and jaundiceImpaired kupffer cells functionEnteric endotoxemia第第25页页/共共68页页26Hepatic encephalopathy(HE)is a primary clinical manifestation of hepatic failure.PART IV Hepatic encephalopathynIntroduction and ConceptionnEtiology and classification nPathog
25、enesis nPrecipitating factors of HEnPrinciples of treatment第第26页页/共共68页页271.Introduction and ConceptionConception of hepatic encephalopathyHE is a complex,potentially reversible disturbance in central nervous system that occurs as a consequence of severe liver diseases.Four stages of hepatic encepha
展开阅读全文