危重新生儿的酸碱失衡

目的 提高对危重新生儿并发酸碱失衡的认识。方法 对405例危重新生儿酸碱失衡类型进行分析。结果 405例危重新生儿动脉血气中351例(86．67％)伴有8种类型的酸碱失衡。其中呼吸性碱中毒(呼碱)合并代谢性酸中毒(代酸)最常见，为99例(28．21％)，其它依次为：代酸85例(24．22％)，呼碱45例(12．82％)，呼吸性酸中毒(呼酸)41例(11．68％)，呼酸合并代酸38例(10．82％)，呼酸合并代谢性碱中毒(代碱)26例(7．41％)，代碱16例(4．56％)，呼碱合并代碱1例(0．28％)，351例酸碱失衡中，单纯性酸碱失衡187例(53．27％)，混合性酸碱失衡164例(46．72％)。结论 危重新生儿原发疾病常引起呼碱或呼酸，病情的发展或不适当的治疗导致代碱，顽固性休克、严重感染、严重低氧血症，消化道出血等引起代酸，严重的呼酸并代酸可导致患儿出现重度的酸血症而致患者死亡。

Acid-base disturbance in newborns with critical diseases

Objective To study the acid-base disturbance i n newborns with critical diseases. Methods The types of acid-ba se disturbance in 405 cases with critical newborn diseases were analyzed. Results There were 8 types of acid-base disturbance in 351 cases,acco unting for 86 67% of the total 405 cases.The 8 types of acid-base disturbance were respiratory alkalosis plus metabolic acidosis(28 21%),metabolic acidosis (24 22%),respiratory alkalosi(12 82%),respiratory acidosis(11 68%),respira tory acidosis plus metabolic acidosis(10 82%),respiratory acidosis plus metabo lic alkalosis (7 41%),metabolic alkalosis (4 56%), and respiratory alkalosis plus metabolic alkalosis (0 28%). 187cases (53 27%) had simple acid-base dist urbance and 164 cases (46 72%),with mixed disturbances. Conclusion Respiratory alkalosis or respiratory acidosis may be primary disorder of newb orns with critical diseases.Metabolic alkalosis can occur with the development o f the primary disease or improper treatment.The metabolic acidosis may be induce d by refractory shock,serious hypoxemia,bleeding in alimentary canal,serious infection and so on.Respiratory acidosis plus metabolic acidosis might separatel y contribute to critical acidemia and result in death.