Electrophysiological method of diagnosis of liver encephalopathy in patients with pancreatitis

Abstract

Acute pancreatitis(AP) remains one of the most urgent issues of modern urgent abdominal surgery. The incidence of AP from year to year is steadily increasing and varies from 23.8 to 58.0% per year. Hepatic renal failure is noted in every fourth patient with severe pancreatitis, which greatly impairs the results of treatment and is the direct cause of death in 40% of cases. Early diagnosis of patients with AP should include detection of hepatic encephalopathy in the latent stage for timely correction of liver failure events. In patients with swollen and destructive pancreatitis, functional deficiency of the liver develops, which greatly complicates the course of the disease and worsens its prognosis. Especially important is the detection of latent AP, which is diagnosed with special psychometric tests, whereas in the standard test of mental status, patients exhibit a norm. The characteristic features of the method for registering indicators of critical frequency of fusion fusion are analyzed. The critical flicker flicker frequency (CFFF) is the maximum frequency of flashes of light that is perceived by the subjects as individual flashing. The method of CFFF is based on the fact that changes in retinal glial cells are similar to those in astrocytes of the brain and are used to determine the latency of AP and severity of apparent hepatic encephalopathy. Allows non-invasive precision, short-range, and reproducible measurements of flicker frequencies. The exclusion criteria for the CFFF test were mental and cerebrovascular diseases, blindness and color blindness. The critical fission fusion rate has been determined in 46 patients with moderately severe and severe acute pancreatitis. Indicators were compared with indicators of the regional norm. The necessity of application of the method of determination of CFFF in acute pancreatitis for the early diagnosis of latent hepatic encephalopathy is substantiated. The validity of the method for the determination of CFFF at different stages of patient monitoring has been confirmed. The substantiated intensive therapy was supplemented with the introduction of LoLa and timely correction of the latent PE phenomena was achieved, which allowed to correct the metabolic disturbances more quickly and reduce the manifestations of endogenous intoxication.