— 生理適應 · MEDIUM · MCQ —
護理師正在照護一位肝硬化病人。哪項發現提示肝性腦病變（hepatic encephalopathy）的發展？
A nurse is caring for a client with cirrhosis. Which finding suggests the development of hepatic encephalopathy?
- AEsophageal varices食道靜脈曲張
- BAsterixis (flapping tremor)✓ 正解撲翼樣震顫
- CAscites腹水
- DJaundice黃疸
— Explanation · 中文詳解 —
肝性腦病變是肝臟無法有效代謝體內氨等毒素所致，其神經學表現之一是撲翼樣震顫（asterixis），即病人伸出雙手時出現不自主的、快速的揮動。黃疸、腹水和食道靜脈曲張是肝硬化的常見表現，但 Asterixis 是肝性腦病變的特異性體徵。
Asterixis, or flapping tremor, is a characteristic neurological sign of hepatic encephalopathy caused by ammonia toxicity. While esophageal varices, ascites, and jaundice are common complications of cirrhosis related to portal hypertension and liver dysfunction, asterixis specifically indicates the neurotoxic effects on the brain.
✦ 台美臨床差異
美國的肝病照護團隊會定期評估肝性腦病變的風險與症狀，並提供病人及家屬相關衛教；台灣的照護模式也強調此點，但病人對症狀的自我察覺與回報很重要。