终末期肝病患者自发性消化道穿孔三例报道及文献复习

目的提高对终末期肝病发生自发性消化道穿孔的认识。方法回顾分析3例终末期肝病患者发生自发性消化道穿孔的临床资料，同时对相关文献进行复习。结果发生自发性消化道穿孔的原因主要与栓塞消化道供血动脉、肝脏功能失代偿和消化道自身疾患有关，行立位腹部平片检查提示膈下游离气体可明确诊断。结论由于发生消化道穿孔病死率较高，所以要以预防为主。已经发生消化道穿孔的患者，积极行手术治疗可提高患者的生存率。

Report of three cases of spontaneous digestive tract perforation in end-stage liver disease and the review of literatures

Objective To improve the knowledge about spontaneous digestive tract perforation in end-stage liver disease. Methods All three cases with spontaneous digestive tract perforation in end-stage liver disease were collected and analyzed retrospectively. Literatures related spontaneous digestive tract perforation in end-stage liver disease were reviewed. Results The major reason of perforation was full of association with embolization of variable digestive artery, decompensation of liver and self-disease of digestion. It was clear when the free air of under diaphragm was found with the abdominal X-ray check. Conclusion We should enhance the preventive therapy because of the high mortality of spontaneous digestive tract perforation in end-stage liver disease. The surgical operation was very important to improve the survival rate if the perforation occurred.