Sawant Prabha, Vashishtha C, Nasa M
Department of Gastroenterology, Lokmanya Tilak Municipal Medical College, Lokmanya Tilak Municipal General Hospital, Sion, Mumbai 400022, India.
Int J Hepatol. 2011;2011:280569. doi: 10.4061/2011/280569. Epub 2011 Jul 19.
Advanced portal hypertension accompanying end-stage liver disease results in an altered milieu due to inadequate detoxification of blood from splanchnic circulation by the failing liver. The portosystemic shunts with hepatic dysfunction result in an increased absorption and impaired neutralisation of the gastrointestinal bacteria and endotoxins leads to altered homeostasis with multiorgan dysfunction. The important cardiopulmonary complications are cirrhotic cardiomyopathy, hepatopulmonary syndrome, portopulmonary hypertension, and right-sided hydrothorax.
晚期肝病伴发的严重门静脉高压会导致内环境改变,原因是肝脏功能衰竭,无法充分清除来自内脏循环的血液中的毒素。肝功能不全导致的门体分流会使胃肠道细菌和内毒素的吸收增加且中和受损,进而导致内环境稳态改变并出现多器官功能障碍。重要的心肺并发症包括肝硬化性心肌病、肝肺综合征、门肺高压和右侧胸腔积液。