盐酸精氨酸治疗脑外伤严重代谢性碱中毒30例分析

目的分析盐酸精氨酸持续微量泵输入治疗脑外伤患者严重代谢性碱中毒的量效关系及对近期患者预后的影响。方法选择成年严重颅脑外伤合并严重碱中毒患者30例,持续微量泵输注盐酸精氨酸0.55 g/（h.kg）,通过血气分析观察治疗前后碱剩余（BE）变化情况,计算精氨酸治疗碱中毒的量效关系。结果盐酸精氨酸治疗严重代谢性碱中毒后,BE下降（11.94±3.45,8.74±3.67,P〈0.001）,pH（7.47±0.06,7.45±0.05,P〈0.05）,PaCO2也同时有下降（49.73±10.48,46.53±9.26,P〈0.05）,Na^＋、Cl^-和K^＋变化不明显;BE下降梯度为△3.19±2.24。结论盐酸精氨酸持续微量泵输入可以有效纠正脑外伤患者严重碱中毒。

The effects of the hydrochloride arginine treatment by intravenous injection continuously on the head injury patients with severe metabolic alkalosis

Objective To observe the effects of the treatment of the hydrochloride arginine on the head injury patients with severe metabolic alkalosis.Methods Thirty adults head injury with severe metabolic alkalosis patients were selected that treated by hydrochloride arginine with amount of 0.55 g/(h·kg) intravenous injection continuously.Standard base excess and pH have been observed by blood gas analysis and calculate the function grad ascent.Results The base excess has decreased significantly after hydrochloride arginine injection(11.94±3.45,8.74±3.67,P<0.001),pH(7.47±0.06,7.45±0.05,P<0.05)and PaCO2(49.73±10.48,46.53±9.26,P<0.05).The base excess function grad ascent is △3.19±2.24.Conclusion The severe metabolic alkalosis in the head injury patients can be treated effectively by the hydrochloride arginine intravenous injection continuously.