Chan C C, Wu H C, Wu C H, Hsu C Y
Division of Gastroenterology, Cathay General Hospital, Taipei, ROC.
J Formos Med Assoc. 1995 Apr;94(4):185-8.
A 52-year-old woman suffered from exertional dyspnea, 5 years after she was diagnosed with cirrhosis of the liver. Hypoxemia was suspected because of persistent exertional dyspnea and was confirmed by contiguous arterial blood gas tests. After excluding other cardiopulmonary factors, a series of studies including lung perfusion scan, echocardiography and cardiopulmonary cineangiography revealed the cause of hypoxemia to be the patient's liver disease. Hepatopulmonary syndrome was diagnosed. Despite supplemental oxygen therapy and oral garlic powder for 6 months, the patient still had exertional dyspnea and platypnea, and arterial blood gas results did not improve. We report this case to call attention to arterial oxygen desaturation in cases of cirrhosis of the liver, and to emphasize that deteriorating oxygenation in patients with chronic liver disease may be an indication for liver transplantation, as such functional microvascular abnormalities could be reversed by liver transplantation.
一名52岁女性在被诊断为肝硬化5年后出现劳力性呼吸困难。由于持续的劳力性呼吸困难怀疑存在低氧血症，并通过连续的动脉血气检查得以证实。在排除其他心肺因素后，一系列检查包括肺灌注扫描、超声心动图和心肺血管造影显示低氧血症的原因是患者的肝脏疾病。诊断为肝肺综合征。尽管进行了6个月的吸氧治疗和口服大蒜粉，但患者仍有劳力性呼吸困难和平卧呼吸，动脉血气结果未改善。我们报告此病例以引起对肝硬化患者动脉血氧饱和度降低的关注，并强调慢性肝病患者氧合恶化可能是肝移植的指征，因为这种功能性微血管异常可通过肝移植得到逆转。
