Objective To evaluate the effect of microecologic treatment combined enteral nutrition on serum endotoxin,tumor necrosis factor-α (TNF-α),interleukin-18 (IL-18),blood ammonia levels and nutritional status in patients with hepatic encephalopathy.Methods 60 patients with hepatic encephalopathy were allocted randomly into 3 groups,on the basis of conventional liver protective therapy and uragogue with one group given probiotics plus enteral nutrition,one given probiotics only,and the 3rd group given intravenous nutrition.The whole course of treatment was four weeks.Serum levels of endotoxin,TNF-α,IL-18,ammonia and albumin were determined before and on the 7th and 14th day after treatment.Results The levels of serum endotoxin,TNF-α,IL-18 and blood ammonia in the combined treatment group decreased remarkably after treatment,while the level of serum albumin elevated markedly.The difference was significant at statistics as compared with the only probiotics group and intravenous nutrition group (P＜0.05).Conclusion Microecologic treatment combined enteral nutrition could effectively reduce blood ammonia and serum endotoxin levels,protect intestinal mucosal barrier,as well as improve nutritional status of patients with hepatic encephalopathy,which was considered as a safe and efficient therapy.