论文部分内容阅读
肝肺综台征(Hepatopulmonary Syndrome,HPS)。首先由 Eriksson 于1988年提出,即肝脏疾病台并肺内分流和灌注障碍引起低氧血症。分析31例 HPS 胸片表现并讨论其意义。一、临床资料男19例,女12例;平均52.23岁;病程平均3.3年。31例肝硬化(肝炎后性15例,酒精性15例,血吸虫性1例)中伴肝癌12例。发生 HPS 血气检测31例 PaO_2≤9.33kPa,其中 PaO_2≤8.80kPa10例。肝功能 child 分级 A 级10例,B 级12例,C 级9例,肺通气功能检测≤60%29例。31例均有不同程度缺氧症状,其中典型直立性呼吸困难4例。查体肝掌6例,皮肤蜘蛛痣7例。辅助检查门静脉高压31例;腹水22例;上消化道出血17例;合并肝肾综合征4例;肝性脑病8例;死亡16例。X 线表现肺改变:肺充血27例,左右不对称18,肺瘀血5例;上腔静脉影宽8例;右肺门影大18例;盘状不张8例;胸水18例;膈肌上移12例。肺内“海棉状”间质性改变、斑点影、粟粒点20例。心脏改变:心胸比>0.5 21例,右室大18例合并左室大5例。肺动脉段膨突10例,右下肺动脉主干≥1.5cm 27例。
Hepatopulmonary Syndrome (HPS). First proposed by Eriksson in 1988, that liver disease stations and pulmonary shunt and perfusion disorders caused by hypoxemia. Analysis of 31 cases of HPS chest radiographs and discuss its significance. First, the clinical data of 19 males and 12 females; mean 52.23 years; duration of an average of 3.3 years. 31 cases of liver cirrhosis (hepatitis after 15 cases, 15 cases of alcoholic, schistosome 1 cases) with liver cancer in 12 cases. HPS blood gas detection occurred in 31 cases of PaO_2≤9.33kPa, PaO_2≤8.80kPa10 cases. Child grade A grade of liver function in 10 cases, B grade in 12 cases, C grade in 9 cases, pulmonary ventilation function test ≤ 60% in 29 cases. All 31 cases had hypoxia symptoms of different degrees, including 4 cases of typical orthostatic dyspnea. Liver palmar examination in 6 cases, 7 cases of skin spider nevus. Assisted examination of portal hypertension in 31 cases; ascites in 22 cases; upper gastrointestinal bleeding in 17 cases; 4 cases with hepatorenal syndrome; hepatic encephalopathy in 8 cases; 16 died. X-ray showed lung changes: 27 cases of pulmonary congestion, left and right asymmetry 18, 5 cases of pulmonary blood stasis; superior vena cava 8 in width; right hilar shadow in 18 cases; 8 cases of atelectasis; pleural effusion in 18 cases; Up 12 cases. Pulmonary “sponge” interstitial changes, speckle, miliary point in 20 cases. Cardiac changes: cardiothoracic ratio> 0.521 cases, right ventricular large 18 cases with left ventricular large in 5 cases. Pulmonary arterial swelling in 10 cases, right lower pulmonary artery ≥ 1.5cm in 27 cases.