慢性肺心病并发复合性酸碱失衡及微机诊断(附310例分析)

310例住院肺心病患者复合性酸碱失衡638例次,以文献中普遍采用的Emmett和Narins分类方法为基础,将肺心病并发复合性酸碱失衡进一步分类,其中二重型9种,三重型7种,四重型2种,计18种。这是一种新的较为合理细致的分类方法,并根据文献中使用的单纯性酸碱失衡代偿预计公式进一步推导出电子计算机诊断复合性酸碱失衡的18个预计公式。经873例次血生化,血气分析,诊断与临床符合率97%。

CHRONIC COR PULMONALE WITH COMPOUND ACID-BASE IMBALANCE AND COMPUTER DIAGNOSIS:AN ANALYSIS OF 310 CASES

Three hundred and ten patients with chronic cor pulmonale who have been admitted to our hospital since 1973 were analysed.Eight hundred and seventy three blood samples were tested for biochemical changes and blood gases.A diagnostic program by using BASIC language was worked out based on the patient's history,anion gap(AG),blood gas analysis,acid- base imbalance compensatory law and compensatory estimated formula. By putting the parameters of Na~+,Cl~-,HCO_3~-,pH,PaCO_2,AB in the com- puter,the computer result will display on the screen after a few seconds and the diagnosis will be printed out within a minute.By using this technique,94.1% of the in-patients with chronic cor pulmonale were found to be complicated with acid-base imbalance;77.6% of them had compound acid-base imbalance.Among patients with compound acid-base imbalance, dual type accounted for 60.1%,triple type 35% and quartet type 4.9%. The diagnostic concordance rate was 97%,undiagnostic rate 2% and mis- diagnostic rate 1%. On the basis of high AG metabolic acidosis and high Cl~- metabolic acidosis proposed by Emmett and Narins,we divided compound acid-base imbalances into 18 kinds:9 kinds of dual type,7 kinds of triple type and 2 kinds of quartet type.We also calculated 18 estimated formulas. There is no doubt that this kind of subtyping is helpful in finding the causes,in diagnosis and in treatment.