Hamm酸碱图在临床中的应用

目的:绘制Hamm酸碱图以指导临床快速准确处理酸碱平衡紊乱。方法:首先利用Hamm公式绘制Hamm酸碱图,并应用Hamm酸碱图对160例患者动脉血气结果进行判断,同时应用代偿公式纯手工计算,比较两种方法的一致性及所花费时间。结果:①应用Hamm酸碱图和纯手工判断单纯性酸碱失衡的一致性,正常为100%,单纯性酸碱失衡为90.5%,二重性酸碱失衡为88.9%,三重性酸碱失衡为82.4%。Kappa一致性检验,两种方法判断结果完全一致(Kappa=0.883,均P<0.01)。②应用Hamm酸碱图对单纯性酸碱失衡42例,二重性酸碱失衡36例,三重性酸碱失衡34例进行判断,所需时间分别为(5.6±0.7)s、(38.5±5.1)s和(40.6±8.7)s,明显少于纯手工计算所需时间的(34.2±3.5)s、(72.4±10.3)s和(92.8±12.2)s,差异有统计学意义(P<0.05)。结论:应用Hamm酸碱图判断酸碱失衡准确、快速、简单。

Clinical application of Hamm acid-base chart

Objective To draw Hamm acid-base chart for estimating the acid-base disorders accurately and rapidly.Method Using Hamm formula to draw acid-base chart.The data of arterial blood gases of 160 cases were analyzed by using Hamm acid-base chart and the pure manual computation independently.Then we compared the consistence and the cost time between two methods.Results(1)The coincidence rate of results obtained by using Hamm acid-base chart and pure manual computation,normal was 100%,single acid-base disorder was 90.5%,double and triple acid-base disorders were 88.9% and 82.4% respectively.The results showed diagnosis using the Hamm acid-base chart were consistent with that with pure manual computation completely((Kappa value=0.883,P<0.01).(2)When Hamm acid-base chart was applied to 42 cases of single acid-base disorder,36 cases of double acid-base disorders and 34 cases of triple acid-base disorders,it took 5.6±0.7 seconds,38.5±5.1 seconds and 40.6±8.7 seconds respectively,which were much less than those of pure manual computation(34.2±3.5 seconds,72.4±10.3 seconds and 92.8±12.2 seconds respectively)(P<0.05).Conclusion The method using the Hamm acid-base chart to analyze acid-base disorders was accurate,simple and rapid.