Halank M, Strassburg C P, Hoeper M M
Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus der TU Dresden, Fetscherstrasse 74, 01307, Dresden, Deutschland.
Internist (Berl). 2010 Mar;51 Suppl 1:255-63. doi: 10.1007/s00108-009-2503-y.
Hepatopulmonary syndrome, portopulmonary hypertension and hepatic hydrothorax are typical pulmonary complications in patients with liver cirrhosis. Whereas hepatopulmonary syndrome and portopulmonary hypertension represent pulmonary vascular diseases, the development of hepatic hydrothorax is associated with the presence of ascites and phrenic lesions. For severe hepatopulmonary syndrome and refractory hepatic hydrothorax, liver transplantation is the treatment of choice. In severe portopulmonary hypertension specific medical treatment is indicated. In selected patients, beside intravenous prostanoids, oral endothelin receptor antagonists and phosphodiesterase type-5 inhibitors are possible treatment options.
肝肺综合征、门脉性肺动脉高压和肝性胸水是肝硬化患者典型的肺部并发症。肝肺综合征和门脉性肺动脉高压属于肺血管疾病，而肝性胸水的发生与腹水及膈病变有关。对于严重的肝肺综合征和难治性肝性胸水，肝移植是首选的治疗方法。对于严重的门脉性肺动脉高压，则需要进行特定的药物治疗。在部分患者中，除静脉使用前列腺素类药物外，口服内皮素受体拮抗剂和5型磷酸二酯酶抑制剂也是可行的治疗选择。
