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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 investigate the changes of blood oxygen in patients with liver cirrhosis and its clinical significance. Methods: Sixty-two patients with post-hepatitis B cirrhosis were selected as the observation group (group A). There were 6 cases of Child-PughA grade, 34 cases of grade B and 22 cases of grade C, and their arterial oxygen saturation (SaO2) and arterial partial pressure of oxygen (PaO2). 35 patients with simple peptic ulcer bleeding at the same period (group B) and 20 normal people (group C) were selected as the control group. The SaO2 and PaO2 values in the three groups were compared. Results: The incidence of hypoxemia in group A was 34% (21/62) and in group B was 0. PaO2 犤 (14.0 ± 0.3) kPa 犦, SaO2 (0.980 ± 0.002) and PaO2 犤 (14.2 ± 0.3) in group C were (10.9 ± 0.1) kPa in group A and 0.963 ± 0.001 in SaO2 kPa 犦, SaO20.981 ± 0.003, there was statistical significance (all P <0.05). However, the PaO2 and SaO2 values between the two groups were not statistically significant. Patients with cirrhosis had statistically significant differences in SaO2 and PaO2 values between different portal vein diameters (more than 14 mm and less than 14 mm), with or without spider nevus, and different liver function grading (A-grade plus B-grade C) All P <0.01). Conclusions: The incidence of hypoxemia in patients with cirrhosis is high, and its severity is related to the diameter of portal vein, the presence or absence of spider nevus and Child-Pugh classification. Early detection of hypoxemia in patients with cirrhosis, help to improve the prognosis of patients with cirrhosis.