肝硬化并发肝性脑病时碱中毒与低氧血症

Alkalosis and hypoxemia in patients with liver cirrhosis accompanied by hepatic encephalopathy

目的 :探讨肝硬化患者并发肝性脑病 (HE)时的碱中毒与低氧血症。方法 :肝硬化患者 6 4例 ;并发HE组 2 1例 ,无HE组 43例。两组均行动脉血气分析 ,并同步检测血清电解质。结果 :酸碱平衡失常 5 4例 (84.4% ) ,其中呼吸性碱中毒 (呼碱 ) 4 8例 (88.9% )。并发HE组与无HE组呼碱发生率分别为 90 .5 %和 6 7.4% (P <0 .0 5 )。 6 4例中动脉低氧血症 42例 (6 5 .6 % ) ,其中重度 6例均为并发HE者。并发HE组与无HE组低氧血症发生率分别为 95 .2 %和 5 1.2 % (P <0 .0 0 5 )。结论 :肝硬化 ,尤其在并发肝性脑病时 ,极易发生碱中毒与低氧血症 ;其中以单纯性呼碱发生率为高。

Objective:To investigate the alkalosis and hypoxemia in patients with liver cirrhosis accompanied by hepatic encephalopathy(HE).Methods:Of the 64 patients with liver cirrhosis,21 cases were accompanied by HE,while 43 cases were not.Arterial blood gas analysis and serum electrolytes were determined in both groups.Results:Fifty four patients were found with disturbance of acid base balance(84.4%).Among them 48 cases had respiratory alkalosis(88.9%).The incidence of respiratory alkalosis in the groups with HE was 90.5%,and in the group without HE 67.4%( P <0.05). Forty two patients were found with arterial hypoxemia in the 64 cases(65.6%) and 6 cases with severe arterial hypoxemia were all in the patients accompanied by HE. In the group with HE and without HE,hypoxemia was 95.2% and 51.2%( P <0.005) respectively.Conclusions:The patients with liver cirrhosis and those accompanied by HE were easy to acquire alkalosis and hypoxemia.Among them,the incidence of simple respiratory alkalosis was the highest.The degrees of PaO 2 decrease affected the prognosis of the patients obviously.