Patient's question:
What is the pathogenesis of hepatic encephalopathy caused by large-volume paracentesis in patients with cirrhosis??Doctor's answer:
Heh, this is a complex issue. In patients with cirrhosis, the balance of electrolytes and acid-base metabolism in the body is disrupted, often leading to hyponatremia, hypochloremia, and hypokalemia, as well as elevated levels of blood ammonia. Ammonia is a neurotoxin; when its levels rise in the body, it enters the bloodstream, enters the brain, and affects the normal functioning of the central nervous system, producing toxic effects. Additionally, large amounts of ascites release can lead to: 1) a sudden increase in intra-abdominal pressure, causing ammonia and other toxic substances to be continuously produced by intestinal metabolism; 2) the expansion of the portal vascular bed, resulting in increased blood flow to the brain and kidneys.