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肝硬化并肾小管性酸中毒(RTA),国内文献报道较少,以反复肝昏迷为首发症状的肝硬化并RTA更为少见,现将我院收治的2例报告如下。例1 男,50岁。肝硬化史4年。1年前反复出现精神、行为异常,大小便失禁,昏迷,平均每月一次。入院时实验室检查:血液生化(mmol/L)K~+2.3,Na~+132,Cl~-114,Ca~(2+)2.15,P0.84,CO_2CP17.25.BUN12.5,Cr159.1。氯化钙试验(+),尿pH值6.0～7.0.胃镜:食道静脉曲张。心电图:符合低钾改变。B超:肝硬化腹水。确诊肝硬化并RTA。予氯化钾、碳酸氢钠、钙剂。Albight液及护肝、支持等治疗,病情明显好转,随访3年,未出现过肝昏迷。例2 男,60岁。肝硬化病史1年,反复肝昏迷半年入院。实验室检查:血生化(mmol/L)K~+2.6,Na~+126,Cl~-110,Ca~(2+)2.2.P0.78,CO_2CP15,BUN7.7,Cr182。氯化钙试验(+),尿pH6.0,血pH7.24。X线照片:骨盆骨质
Cirrhosis and renal tubular acidosis (RTA), less reported in the domestic literature, with recurrent hepatic coma as the first symptom of cirrhosis and RTA more rare, now in our hospital were treated 2 cases reported as follows. Example 1 male, 50 years old. History of cirrhosis 4 years. A year ago, repeated spirits, abnormal behavior, incontinence, coma, on average once a month. Laboratory examination on admission: Blood biochemistry (mmol / L) K ~ + 2.3, Na ~ + 132, Cl ~ -114, Ca ~ (2+) 2.15, P0.84, CO_2CP17.25.BUN12.5, Cr159. 1. Calcium chloride test (+), urine pH 6.0 ~ 7.0. Gastroscope: Esophageal varices. ECG: in line with low potassium changes. B ultrasound: cirrhosis and ascites. Confirmed cirrhosis and RTA. To potassium chloride, sodium bicarbonate, calcium. Albight fluid and liver protection, support and other treatment, the condition improved significantly, followed up for 3 years, no hepatic coma. Example 2 male, 60 years old. A history of cirrhosis 1 year, repeated hepatic coma six months admitted. Laboratory tests: Blood biochemistry (mmol / L) K ~ +2.6, Na ~ +126, Cl ~ -110, Ca ~ (2+) 2.2.P0.78, CO_2CP15, BUN7.7, Cr182. Calcium chloride test (+), urine pH6.0, blood pH7.24. X-ray: pelvic bone