Nacif Lucas Souto, Andraus Wellington, Sartori Kathryn, Benites Carlos Marlon, Santos Vinicius Rocha, Rocha-Filho Joel Avancini, D'Albuquerque Luiz Carneiro
Department of Gastroenterology, School of Medicine, University of Sao Paulo, Sao Paulo, SP, Brazil.
Arq Bras Cir Dig. 2014 Jan-Mar;27(1):56-8. doi: 10.1590/s0102-67202014000100014.
Hepatopulmonary syndrome is formed by a triad of liver disease, intrapulmonary vascular dilatation and changes in blood gases. This condition is present in 4-32% of patients with cirrhosis.
To analyze the blood gas changes data of patients in liver-transplant waiting list.
Clinical data of 279 patients in liver transplantation waiting list in May 2013 were studied. Overall patient was analyzed by the demographic aspects, laboratorial and image findings on exams that determine lung disease (hypoxemia) in these cirrhotic patients. The mean values and standard deviations were used to examine normally distributed variables.
There was a high prevalence of male patients (68%); the mean age was 51(± 5,89) years, and the predominant reason for listing was hepatitis C cirrhosis. The MELD score mean was 16 ± 5,89, without prioritization or special situation. The most common blood type was O in 129 cases (46%) and the mean of body max index was 25,94 ± 4,58. Regarding arterial blood gas tests was observed 214 patients with PaO2 <90 mmHg, 80 with PaO2 <80 mmHg and 39 with PaO2 <50 mmHg. In relation to O2 saturation, 50 patients had <90%, 33 <80% and 10 <50%.
Was observed a high rate of hypoxemia in patients on waiting list liver transplant. Due to the high severity and morbidity, is suggested better monitoring and therapeutic support to hypoxemic patients on liver transplant waiting list.
肝肺综合征由肝病、肺内血管扩张和血气变化三联征构成。这种情况在4% - 32%的肝硬化患者中存在。
分析肝移植等待名单上患者的血气变化数据。
研究了2013年5月在肝移植等待名单上的279例患者的临床资料。通过人口统计学方面、实验室检查和影像学检查结果对这些肝硬化患者中确定肺部疾病(低氧血症)的总体患者进行分析。使用均值和标准差来检验正态分布变量。
男性患者患病率较高(68%);平均年龄为51(±5.89)岁,列入名单的主要原因是丙型肝炎肝硬化。平均终末期肝病模型(MELD)评分为16±5.89,无优先排序或特殊情况。最常见的血型是O型,有129例(46%),平均体重指数为25.94±4.58。关于动脉血气检查,观察到214例患者动脉血氧分压(PaO2)<90 mmHg,80例PaO2<80 mmHg,39例PaO2<50 mmHg。关于氧饱和度,50例患者<90%,33例<80%,10例<50%。
观察到肝移植等待名单上的患者低氧血症发生率较高。由于严重程度和发病率较高,建议对肝移植等待名单上的低氧血症患者进行更好的监测和治疗支持。