title: Early diet intervention to reduce the incidence of hepatic encephalopathy in cirrhosis patients: post-Transjugular Intrahepatic Portosystemic Shunt (TIPS) findings.
abstract: OBJECTIVE
  Hepatic encephalopathy is a common complication in patients who have received transjugular intrahepatic portosystemic shunt (TIPS) as treatment for cirrhosis. The objective of this study was to reduce the incidence of post-TIPS hepatic encephalopathy for these patients via positive diet intervention.
  
  
  METHODS
  As a control group, 99 cirrhosis patients who underwent TIPS treatment in our department between August 2011 and February 2013 were chosen. Among these, postoperative hepatic encephalopathy occurred in 28 cases. After analyzing the possible causes and incentives of hepatic encephalopathy by applying retrospective analysis, it was seen that hepatic encephalopathy was caused mostly by improper diet (85.7%). The experimental group was comprised of 83 cirrhosis patients who underwent TIPS treatment during the period from May 2013 to September 2014. In view of the influence of improper diet, appropriate intervention measures were taken, including developing a postoperative nursing routine, training nurses about nutrition and the protein content of kinds of various common foods, customizing low-protein meals, training nurses in communication skills to improve the education of patients and establishing family support systems.
  
  
  RESULTS
  For the experimental group, hepatic encephalopathy occurred in 10 patients, for an incidence of 12.1%, which is significantly lower than the control group (28.3%). This is a statistically significant difference (p<0.01) in the occurrence of this complication.
  
  
  CONCLUSIONS
  After TIPS, early positive dietary intervention can significantly improve the compliance of cirrhosis patients to consume a low-protein diet and reduce the incidence of hepatic encephalopathy.
authors.affiliation: Infectious Diseases Department, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China. Email: 314620906@qq.com.
authors.forename: Ling
authors.initials: L
authors.lastname: Luo
authors.affiliation: Infectious Diseases Department, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
authors.forename: Shiying
authors.initials: S
authors.lastname: Fu
authors.affiliation: Infectious Diseases Department, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
authors.forename: Yunzhi
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Infectious Diseases Department, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
authors.forename: Jingxiang
authors.initials: J
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D004032:Diet; D018753:Diet, Protein-Restricted; D005260:Female; D006501:Hepatic Encephalopathy / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D006801:Humans; D008103:Liver Cirrhosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D019168:Portasystemic Shunt, Transjugular Intrahepatic / Q000009:adverse effects*; D012189:Retrospective Studies