肝硬化患者过度通气及呼吸性碱中毒的临床意义

The Clinical Significance of Hyperventilation and Respiratory Alkalosis in the Patients with Liver Cirrhosis

目的：探讨肝硬化患者过度通气及其引起的呼吸性碱中毒的临床意义。方法：97例诊断明确的肝硬化患者。其中代偿期肝硬化34例；失代偿期肝硬化无肝性脑病35例；失代偿期肝硬化合并肝性脑病的28例。所有病例均进行动脉血气分析,比较3组患者低二氧化碳血症和呼吸性碱中毒的发生率及严重程度。结果：①代偿期肝硬化组、失代偿期肝硬化无肝性脑病组、失代偿期肝硬化合并肝性脑病组低二氧化碳血症发生率依次增高(P＜0．01)；3组PaCO_2依次降低(P＜0．01)；②代偿期肝硬化组、失代偿期肝硬化无肝性脑病组、失代偿期肝硬化合并肝性脑病组呼吸性碱中毒的发生率依次增高(P＜0．05),呼吸性碱中毒也依次加重(P＜0．01)。结论：肝硬化患者随着肝功能的减退,容易发生过度通气,而过度通气造成呼吸性碱中毒,进一步加重肝硬化患者的病情。在治疗肝硬化时应注意监测和纠正酸硷紊乱。

Objective：To investigate the clinical significance of hyperventilation and respiratory alkalosis in the patients with liver cirrhosis. Methods：Of the 97 patients with liver cirrhosis, the 34 cases suffer from compensatory phase hepatocirrhosis, the 35 cases from decompensation hepatocirrbosis without hepatic encephalopathy, and the 28 cases from decompensation hepatocirrhosis with hepatic encephalopathy. All arterial blood gas measurements were performed. The incidences and serious degree of the hypocapnia ＆ respiratory alkalosis were compared among the three groups. Results： （1）The incidences of the hyperventilation in the three groups mentioned above increased in turn（P〈0. 01 = , while the PaCO2 of the patients decreased in turn （P〈0.01）. （2） The incidences of the respiratory alkalosis in the three groups of the patients with liver cirrhosis increased in turn（P〈0.05）, meanwhile, it was more serious in turn（P〈0. 01 ）. Conclusion：With the hepatic function decreasing, the pa dents with liver cirrhosis is likely to suffer from the abnormal hyperventilation, which leads to the respiratory alkalosis and fur ther makes the illness more serious. In clinical practice, the hyperventilation and acid-base disorders in the patients with liver cirrhosis should be monitored and corrected.