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目的:了解肝硬化患者并发肝肺综合征的临床特点,以及经高压氧治疗后疾病的转归情况。方法:根据动脉血气分析Pa02<10.64Kpa和/或P02(A-a)≥2Kpa分为肝肺综合征组和对照组,2组之间进行临床症状、体征、辅助检查等方面对比分析。将肝肺综合征组随机分为两组分别给予常压吸氧和高压氧舱治疗10天复查肝功、胆红质、腹水量、血气分析,然后进行对比分析。结果:肝肺综合征组(Pa02<10.64Kpa和/或P02(A-a)≥2Kpa)共42例,占38.89%。无低氧血症组即对照组为66例,占61.11%。呼吸困难、蜘蛛痣、杵状指、腹水、门静脉宽度、食道静脉曲张在低氧血症组中的阳性率明显高于对照组,两者之间存在显著性差异(P<0.05),黄疸升高、转氨酶升高、影像改变、child分级所占的比例在2组之间无显著性差异(P>0.05);与治疗前比较,常压组和高压氧组在治疗10天后各项指标均有显著性差异(P<0.05或P<0.01);常压组和高压氧组在治疗后各指标比较,2组之间存在显著性差异(P<0.05或P<0.01)。结论:肝硬化合并肝肺综合征患者病人出现呼吸困难、胸腹水、杵状指、蜘蛛痣、食管静脉曲张、门静脉增宽(大于1.4CM)比率明显高于单纯肝硬化无低氧血症者;高压氧可有效改善肝肺综合征。
Objective: To understand the clinical characteristics of patients with liver cirrhosis complicated with hepatopulmonary syndrome, as well as the prognosis of the disease after hyperbaric oxygen therapy. Methods: According to arterial blood gas analysis, Pa02 <10.64Kpa and / or P02 (A-a)> 2Kpa were divided into hepatopulmonary syndrome group and control group, and the clinical symptoms, signs and auxiliary examinations were compared between two groups. The hepatopulmonary syndrome group was randomly divided into two groups were given atmospheric oxygen and hyperbaric oxygen chamber treatment for 10 days review of liver function, bilirubin, ascites, blood gas analysis, and then comparative analysis. Results: In the group of hepatopulmonary syndrome (Pa02 <10.64Kpa and / or P02 (A-a)> 2Kpa), a total of 42 cases accounted for 38.89%. No hypoxemia group that control group was 66 cases, accounting for 61.11%. The positive rate of dyspnea, spider mole, clubbing, ascites, portal vein width and esophageal varices in the hypoxemia group was significantly higher than that in the control group, there was a significant difference between the two groups (P <0.05) High, aminotransferase increased, image changes, the proportion of child grading in the two groups no significant difference (P> 0.05); compared with before treatment, the normal pressure group and hyperbaric oxygen group after treatment for 10 days were (P <0.05 or P <0.01). There was significant difference between the two groups after treatment (P <0.05 or P <0.01). Conclusions: Patients with cirrhosis and hepatopulmonary syndrome have dyspnea, and the rates of thoracic ascites, clubbing, spider nevus, esophageal varices, and portal vein widening (greater than 1.4 cm) are significantly higher than those without hypoxemia Hyperbaric oxygen can effectively improve hepatopulmonary syndrome.