Byrd R P, Roy T M, Simons M
Division of Pulmonary Medicine, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, USA.
South Med J. 1996 Jul;89(7):689-92. doi: 10.1097/00007611-199607000-00008.
Seventeen patients with biopsy-confirmed hepatic cirrhosis and tense ascites performed reproducible pulmonary functions and had arterial blood gas analysis before and after having a therapeutic large volume paracentesis. Each patient showed significant improvement in the static lung volumes as determined by helium dilution techniques. Dynamic airflow also improved as expressed by the FVC and the FEV1. The FEV1/FVC ratio remained unchanged. Each patient showed a significant improvement in oxygenation 120 minutes after LVP. Alveolar ventilation as expressed by PaCO2 did not change. The pathophysiology that explains the improvement in oxygenation remains speculative. Large volume paracentesis appears to have a salutary effect on oxygenation, as well as on pulmonary function.
17例经活检证实为肝硬化且有大量腹水的患者在进行治疗性大量腹腔穿刺放液前后进行了可重复的肺功能检查及动脉血气分析。通过氦稀释技术测定，每位患者的静态肺容量均有显著改善。以用力肺活量（FVC）和第1秒用力呼气容积（FEV1）表示的动态气流也有所改善。FEV1/FVC比值保持不变。每位患者在大量腹腔穿刺放液后120分钟时氧合情况有显著改善。以动脉血二氧化碳分压（PaCO2）表示的肺泡通气未发生变化。解释氧合改善的病理生理学机制仍属推测。大量腹腔穿刺放液似乎对氧合以及肺功能都有有益作用。
