肝硬化失代偿期患者肝储备功能与动脉血氧相关性研究

Liver function and arterial blood oxygen reserves correlation Study in patients with decompensated cirrhosis

[目的]探讨肝硬化失代偿期患者动脉血氧分压(PaO2)、氧饱和度(SaO2)和二氧化碳分压(PaCO2)的变化,评价动脉血氧在肝肺综合征(HPS)临床诊断中的价值,为诊断和预防HPS提供理论依据。[方法]应用血气分析仪测定60例肝硬化失代偿期患者(肝硬化组)及同期住院60例非肝硬化失代偿者(对照组),比较2组的PaO2、SaO2、PaCO2。并比较肝硬化组Child-Pugh为A、B、C间的PaO2、SaO2、PaCO2。[结果]肝硬化组患者低氧血症发生率为48%。①肝硬化组PaO2与对照组PaO2比较P<0.01,而肝硬化组和对照组SaO2、PaCO2值水平比较差异无统计学意义(P>0.05);②肝硬化Child-Pugh A、B、C 3级间PaO2,SaO2值比较差异有统计学意义(P<0.01),而3级间PaCO2水平比较差异无统计学意义(P>0.05),且PaO2、SaO2值随着Child-Pugh分级的增高呈下降趋势。[结论]肝硬化患者低氧血症发生率高,其发生率随着Child-Pugh分级的增高而呈梯形上升。血气分析对HPS有诊断价值。

[Objective]To investigate patients with decompensated cirrhosis the arterial oxygen （PaO2）, oxygen saturation of arterial blood（SaO2） and the partial pressure of carbon dioxide （PaCO2） changes in the evaluation of arterial blood oxygen hepatopulmonary syndrome clinical diagnostic value for the diagnosis and prevention hepatopulmonary syndrome and provide a theoretical basis. [Methods] Sixty cases of liver decompensated cirrhosis in patients were selected. Blood Gas Analycer was used to measure arterial oxygen pressure, oxygen saturation, carbon dioxide partial pressure. The same period hospitalization normal 60 cases for the control were selected. The PaO2 and SaO2, PaCO2 were compaired. Decompensated cirrhosis of the liver function in patients were undertaken Child-Pugh classification. A 17, B 27, C 16 cases. PaO2 and SaO2, PaCO2 were compaired among the different classification. [Results] The incidence of hypoxemia in patients with liver cirrhosis was 48 percent. ① PaO2 was markedly different between cirrhosis group and normal control group （P〈0. 01）, and the levels of SaO2, PaO2 had no difference between liver cirrhosis group and normal control group（P〉0. 05） ;②PaO2 and SaO2 values existed signifi-cantly difference between the different grade of Child-Pugh classification（P〈0. 01）, but PaCO2 levels had no difference（P〉0. 05）, with the Child-Pugh classification increasing, PaO2 and SaO2 values showed a downward trend. [Conclusion ]The incidence of hypoxemia in patients with liver cirrhosis high. ② With the incidence of hypoxemia Child-Pugh classification of liver function and a higher ladder up. ③ Blood gas analysis on hepatopulmonary syndrome has diagnostic value. ④ Patients with cirrhosis should be done as early as blood gas analysis.