肝硬化患者的血氧变化及临床意义──附62例分析

Hypoxemia and its clinical significance in patients with liver cirrhosis

目的:探讨肝硬化患者的血氧变化及临床意义。方法:乙型病毒性肝炎后肝硬化患者62例为观察组(A组),其中Child-PughA级6例,B级34例,C级22例,采用血气分析仪测定其动脉血氧饱和度(SaO2)和动脉血氧分压(PaO2)。选同期单纯消化性溃疡并出血35例(B组)和正常人20名(C组)作对照组,比较3组的SaO2和PaO2值。结果:A组的低氧血症发生率为34%(21/62),B组为0。A组的PaO2为(10.9±0.1)kPa、SaO2为0.963±0.001,分别与B组的PaO2犤(14.0±0.3)kPa犦、SaO2(0.980±0.002)和C组的PaO2犤(14.2±0.3)kPa犦、SaO20.981±0.003比较,有统计学意义(均为P<0.05)。而B、C两组间PaO2和SaO2值比较无统计学意义。肝硬化患者不同门静脉内径(超过14mm比小于14mm)、有或无蜘蛛痣、不同肝功能分级(A级加B级比C级)的SaO2和PaO2值比较,均有非常显著的统计学意义(均为P<0.01)。结论:肝硬化患者低氧血症的发生率高,其严重程度与门静脉内径、有无蜘蛛痣和Child-Pugh分级有关。早期发现肝硬化患者的低氧血症,有助于改善肝硬化患者的预后。

Objective:To study the incidence of hypoxemia and its clinical significance in patients with liver cirrhosis. Methods:The partial pressure of oxygen (PaO2) and oxygen saturation of arterial blood (SaO2) in 62 cases with po st hepatitis liver cirrhosis (group A) were examined by automatic blood gas anal yser. Of them 6 were classified as Child Pugh A,34 Child Pugh B and 22 Child Pugh C. At the same time,35 cases (group B) with simple peptic ulcer complica ting with bleeding and 20 cases (group C) healthy volunteers were studied as con trols. Results:The PaO2 and SaO2 in patients with liver cirrhosis were (10.9±0 .1) kPa and 0.963±0.001 respectively. The PaO2 and SaO2 were (14.2±0.3) kPa,0 .980±0.002 in group B,and (14.2±0.3) kPa,0.981±0.003 in group C,respective ly. The difference was significant (P<0.05). Compared the cirrhosis patients tha t have different portal vein bore (>14 mm vs<14 mm),have nevus araneus or not a nd have different Child Pugh grade (A+B vs C),the difference in SaO2 and PaO2 was significant (P<0.01). Conclusion:The incidence of hypoxemia is high in pat ients with liver cirrhosis. Severity of hypoxemia is related with portal vein in ner diameter,spider angioma and Child Pugh grade.