肝肺综合征临床研究（附45例分析）

目的探讨肝肺综合征（HPS）的临床特点。方法回顾性分析我院2007年1月-2008年12月收治的肝硬化患者88例。结果其中45例合并HPS,发生率51.14%。胸部X线检查表现正常6例（13.34%）,表现为肺纹理增多,间质性浸润样改变共39例（86.66%）,Child-pugh分级B级与C级较A级发生率显著增高（P〈0.01）。有肝硬化失代偿表现如蜘蛛痣、腹水、脾大、门静脉增宽及胃底食管静脉曲张者HPS发生率明显增高（P〈0.01）。肺功能检查主要表现为肺弥散功能损害占50%,限制性通气障碍占20%,混合性通气功能障碍占30%。结论HPS是肝硬化的常见并发症,尽早行必要的血气分析有助于HPS的诊断。

Clinical study of hepatopulmonary syndrome(Analysis of 45 cases)

Objective To investigate the clinical features of hepatopulmonary syndrome （HPS）. Methods Retrospective analysis 88 cases of liver cirrhosis cases in our hospital from January 2007 to December 2008. Results The incidence of hepatopulmonary syndrome is 51.14% in 45 patients with HPS. six cases,in normal with Chest X-ray examination, accounting for 13.34% ,demonstrated increased lung marking. 9 cases of like change is interstitial infiltration in 39 case, accounting for 86. 66% , Child-pugh grade class A significantly higher than class B and class C （P〈0. 01 ）. There have Cirrhosis demonstrated spider such as ascites, splenomegaly. HPS were significantly higher incidence（P〈0. 01 ） in Portal and widened gastric esophageal varices. The main performance of pulmonary function tests that 50% of all the case in pulmonay diffusing capacity for damage, 20% restrictive barriers to ventilation, mixed-ventilation dysfunction accounted for 30%. Conclusion HPS is a common complication of liver cirrhosis, as soon as possible check the blood gas analysis help to the diagnosis of HPS.