肝性胸腔积液特点对肝硬化预后的指导价值  

Feature of hepatic hydrothorax and its clinical guiding value to the prognosis of liver cirrhosis

作　　者：刘作功[1] 公丕欣[2] 

机构地区：[1]山东省卫生教育培训中心,山东济南250014 [2]泰山医学院附属医院

出　　处：《齐鲁护理杂志（下旬刊）》2012年第12期18-19,共2页Journal of Qilu Nursing

摘　　要：目的:探讨肝性胸腔积液(漏出液)的特点以及对终末期肝病病例预后的指导价值。方法:收集呼吸科住院确诊肝性胸腔积液患者70例,所有患者均行心脏超声、胸部X线及CT、肾功能等检查,除外其他原因引起的胸腔积液。胸腔积液进行比色、李凡它试验(蛋白含量)、细胞计数、细菌数检测。结果:胸腔积液呈漏出性(淡黄色、李凡它试验阴性,细胞数少)61例,渗出性胸腔积液9例,经保肝、利尿、白蛋白等治疗后48例几近吸收,14例好转,另有8例患者变化不明显,本组中8例患者死亡,主要原因门脉高压、肝性脑病、低蛋白血症及消化道出血。结论:肝性胸腔积液虽然相对少见,应高度重视,其中胸腔积液量、性质、出现时间与预后密切相关,积极地综合治疗可以明显改善预后。死因主要为门脉高压、消化道出血、肝肾综合征、电解质紊乱等。Objective ： To study the feature of hepatic hydrothorax （ transudate ） and its clinical guiding value to the prognosis of end - stage liver disease. Methods-70 hospitalized patients who were diagnosed of hepatic hydrothorax in the department of respiration received cardiac ultrasound, chest X - ray, CT scan and renal function examination, excluding other causes of pleural effusion. The colorimetric anal- ysis of pleural effusion, Rivalta test （ protein content） , cell count and bacterial detection were made. Results ： The transudative hydrothorax was found in 61 cases （ pale yellow, Rivaha test was negative, number of ceils was fewer） ;exudative hydrothorax was found in 9 cases. The hydrothorax was almost absorbed in 48 cases after proper treatment with hepatoprotective, diuretic and albumin ; improvement in 14 cases and no obvious change in 8 cases. 8 patients died and the main causes of death were portal hypertension, hepatic encephalopathy, hypoalbu- minernia and hemorrhage of digestive tract. Conclusion ： Much attention should be paid to the appearance of hepatic hydrothorax although it is relatively rare. The prognosis of the patients is closely related to the amount of hydrothorax, nature and time of its appearance. The actively comprehensive treatment can significantly improve prognosis.

关 键 词：肝硬化 胸腔积液 腹水 

分 类 号：R473.5[医药卫生—护理学]