肝硬化并发肺部病变100例临床剖析.docVIP

肝硬化并发肺部病变100例临床剖析 　　摘 要 目的：探讨肝硬化并发肺部病变的原因及其与Child-pugh分级的关系和治疗措施。方法：总结近年来资料完整的100例肝硬化住院病人并发胸水、肺炎、肺结核、肺不张等情况和相关治疗措施。结果：肝硬化并发肺部病变以并发胸水为最多，肝性胸水与Child- pugh分级有关联，对于肝性胸水患者提倡及早诊断，综合治疗。 肝硬化易并发肺炎和肺结核。肝硬化并发肺炎应及早做细菌培养，合理应用抗菌药物，加强支持保肝治疗。肺结核的治疗应遵循早期、适量、规律、联合、全程的化疗方案，强调早期、适量，以肝功能的变化作为调整药物和剂量的依据。 　　关键词 肝硬化 肺部病变 　　doi:10.3969/j.issn.1007-614x.2009.11.023? 　　 　　Abstract Purpose:to discuss cause for hepatocirrhosis complicated by pathological changes of lung and Child-pugh hierarchical relation and treatment measures.Method: summarize 100 cases of hepatocirrhosis inpatients complicated by hydrothorax,pneumonia,phthisis,atelectasis and more situations and relevant treatment measures with integral data in our hospital in recent years.Result:Hepatocirrhosis complicated by pathological changes of lung is mostly complicated by hydrothorax.Hepatic hydrothorax is related to Child-pugh classification.It is advocated for hepatic hydrothorax patients to see a doctor for diagnoses and complex treatment as soon as possible.Hepatocirrhosis is easily complicated by pneumonia and phthisis.The germiculture shall be conducted as soon as possible in treatment for hepatocirrhosis complicated by pneumonic to reasonably apply antibacterials and intensify treatment for liver protection.The regular,combined and full range chemotherapy scheme with proper quantities at early stage shall be followed for phthisical treatment,with early stage and proper quantities emphasized,variance in liver function as the basis of adjusting drug and dosage. 　　Key wordsHepatocirrhosis pathological changes of lung? 　　 　　肝硬化是消化内科常见疾病，易并发胸水、肺炎、肺结核、肺不张等肺部病变。本文总结我院近年来资料完整的100例肝硬化住院病人，并发胸水，肺炎，肺结核、肺不张等情况和相关治疗措施。并探讨肝性胸水、肺部病变与Child-pugh分级的关系及治疗措施，分析如下。 　　 　　资料与方法 　　 　　一般资料：本组肝硬化住院病人100例，男72例，女28例；年龄16～84岁，平均50岁，40岁以上者75例，占75%；病程3天～30年，平均7.8年。 　　诊断标准：所有病人均有典型肝硬化表现，肝功能受损，白球蛋白倒置，并有门脉高压的客观证据，同时除外其他原因所致门脉高压。 　　 　　结 果 　　 　　100例肝硬化并发肺部病变共50例，发生率50%；胸水30例，发生率30%，其中右侧胸水18例，左侧胸水8例，双侧胸水4例，分别占60%、26.7%、13.3%。30例胸水中4例无腹水，占13.3%。