慢性肝衰竭和失代偿期肝硬化患者血气分析的变化

目的探讨慢性肝衰竭和失代偿期肝硬化患者血气分析变化的临床意义。方法回顾性分析我科收治的37例慢性肝衰竭和失代偿期肝硬化患者的血气分析资料。结果2例患者出现明显的缺氧表现，4例患者出现立位性缺氧表现，11例患者感轻度胸闷；在36例存在酸碱失衡的患者，慢性肝衰竭组存在单纯酸碱失衡9例，两重酸碱失衡10例，三重酸碱失衡2例，失代偿期肝硬化组存在单纯酸碱失衡8例，两重酸碱失衡7例。两组患者在酸碱失衡的类型方面无统计学差异；两组均以碱中毒为主。慢性肝衰竭组中比例较高的三种类型依次为呼吸性碱中毒合并代谢性酸中毒（38．1％）、呼吸性碱中毒（23．8％）和代谢性碱中毒（14．3％），单纯性代谢性酸中毒比例最低（4．8％）。失代偿期肝硬化组中比例较高的三种类型依次为呼吸陛碱中毒（46．7％）、呼吸性碱中毒合并代谢性碱中毒（26．7％）和呼吸性碱中毒合并代谢性酸中毒（20．0％），代谢性碱中毒比例最低（6．7％）。结论慢性肝衰竭和失代偿期肝硬化患者存在酸碱失衡和低氧血症，动态监测血气分析并及时对症治疗对此类患眷具有重要的临床意义。

Blood gas analysis in patients with chronic liver failure and decompensated cirrhosis

Objective To investigate the changes of blood gas analysis in patients with chronic liver failure and decompensated cirrhosis. Methods The blood gas analysis in 37 patients with chronic liver failure and decompensated cirrhosis were analyzed. Results Two patients had hypoxia,four patients had orthostatic hypoxia and ll patients had mild chest tightness. 36 patients had acid-base imbalance in chronic liver failure group,nine had a simple,ten double and two triple acid-base imbalance;in decompensated cirrhosis group,eight had simple and 7 double acid-base imbalance;alkalosis-based type of acid-base imbalance was common in both of the two groups. In chronic liver failure group, the three major types were respiratory alkalosis with metabolic acidosis（38.1%）, respiratory alkalosis（23.8% ）, and metabolic alkalosis （14.3%）. In decompensated cirrhosis group,the three major types were respiratory alkalosis （46.7%）,respiratory alkalosis with metabolic alkalosis（26.7%）,and respiratory alkalosis with metabolic acidosis（20.0%）. Conclusion Chronic liver failure and decompensated cirrhosis patients have acid-base imbalance and hypoxemia. Dynamic monitoring of blood gas might have a clinical significance.