Kitano S, Iso Y, Yamaga H, Hashizume M, Wada H, Sugimachi K
Department of Surgery II, Kyushu University Faculty of Medicine, Fukuoka, Japan.
Eur Surg Res. 1988;20(5-6):298-303. doi: 10.1159/000128777.
In 34 cirrhotic patients with esophageal varices, a significant but temporary deterioration in pulmonary function tests occurred 24 h after endoscopic injection sclerotherapy using 5% ethanolamine oleate. Included were vital capacity, forced expiratory volume in 1 s, closing volume/vital capacity and arterial oxygen content. Twenty-four hours after the sclerotherapy, the patients complaining of postinjection retrosternal pain had a larger fall in vital capacity and forced expiratory volume in 1 s than did the patients without pain. Before the injection sclerotherapy, 11 of 34 patients had an arterial hypoxemia (PaO2 less than 80 mm Hg). In these patients, there was a significantly (p less than 0.001) higher value of closing volume before sclerotherapy and there were larger changes in both closing volume (p less than 0.01) and arterial oxygen content (p less than 0.01) 24 h after the injection sclerotherapy than in the patients without hypoxemia. Reversion to a state before sclerotherapy was attained 7 days after the sclerotherapy. Thus, patients undergoing sclerotherapy for bleeding esophageal varices should be closely monitored with regard to pulmonary function.
在34例患有食管静脉曲张的肝硬化患者中，使用5%油酸乙醇胺进行内镜注射硬化治疗24小时后，肺功能测试出现了显著但暂时的恶化。其中包括肺活量、一秒用力呼气量、闭合气量/肺活量和动脉血氧含量。硬化治疗24小时后，主诉注射后胸骨后疼痛的患者肺活量和一秒用力呼气量的下降幅度大于无疼痛的患者。在注射硬化治疗前，34例患者中有11例存在动脉低氧血症（动脉血氧分压低于80 mmHg）。在这些患者中，硬化治疗前闭合气量的值显著更高（p<0.001），并且在注射硬化治疗24小时后，闭合气量（p<0.01）和动脉血氧含量（p<0.01）的变化均大于无低氧血症的患者。硬化治疗7天后恢复到硬化治疗前的状态。因此，对于因食管静脉曲张出血而接受硬化治疗的患者，应密切监测其肺功能。
