慢性肺心病急性加重期合并三重酸碱失衡分析

目的探讨慢性肺心病急性加重期的酸碱失衡类型和三重酸碱失衡(TABD)的临床诊断指标。方法47例慢性肺心病急性加重期患者,同步测定动脉血气和血清电解质。以酸碱失衡预计代偿公式,阴离子隙(AG)值和潜在HCO3-,进行酸碱失衡类型判断。结果43例患者发生酸碱失衡,其中单纯酸碱失衡28例次,二重酸碱失衡21例次,三重酸碱失衡5例次。所有TABD患者均伴有多脏器衰竭,死亡率远高于其他患者(P<0.01)。结论慢性肺心病急性加重期患者出现多种类型酸碱失衡,临床诊断TABD必需以酸碱失衡预计代偿公式、AG值和潜在HCO3-联合才更为可信。

Diagnosis of Triple Acid-base Disturbance in Patients with Acute Exacerbation of Chronic Pulmonary Heart Disease

Objective To determine the type of acid-base disturbance in the patients with acute exacerbation of chronic pulmonary heart disease and evaluate the indexes of triple acid-bose distur bance (TABD) for clinical diagnosis.Methods The arterial blood gas and serum electrolytes from 47 patients with acute exacerbation of chronic pulmonary heart disease were analyzed.The expected compensatory formula of acid-base distubance was utilized to determine the type of acid-base disturbance combined with AG value and potential HCO_3 -.Results There were 43 cases with variant acid-base disturbance,in which simple,double,and triple acid-base disturbances were detected for 28,21 and 5 person-time respectively.All the TABD patients indicated multiple organ failure,whose mortality was much higher than that of the other patients.Conclusion Variant types of acid-base disturbance will appear in the patients with acute exacerbation of chronic pulmonary heart disease.The AG value and potential HCO_3 - should be combined with expected compensatory formula of acid-base disturbance due to their clinical limitations.