88例SARS患者的血气分析及临床研究

为探讨SARS患者血氧代谢的特点及其与临床的相关性,采用回顾性分析研究的方法。结果1)我院88例SARS患者共检测血气213例次,血气异常率以动脉血氧分压(PaO2)降低最多见,为85.0%(181/213例次),动脉血氧饱和度(SaO2)降低占68.1%(145/213例次),动脉二氧化碳分压(PaCO2)增高仅占5.6%(12/213次)。表明SARS患者低氧血症发生率最高,二氧化碳储留不多见。2)低氧血症与临床病型和病期相关,重型、极重型较普通型SARS的缺氧表现明显,病程进展期和极期PaO2较低下。3)多数SARS患者存在呼吸性碱中毒(简称呼碱)。死亡病例除呼碱外,常有复合性酸碱紊乱。结果提示1)SARS患者病程初期即有PaO2降低,低氧血症刺激过度通气,PaCO2降低引起呼碱,进一步发展为复合性酸碱失衡,或表现为CO2储留,导致呼吸性酸中毒(简称呼酸)。2)低氧血症与临床病情及预后相关,治疗中应重视早期给氧治疗。

Clinical Analysis of Blood Gas in 88 Patients with Severe Acute Respiratory Syndrome

The objective was to discuss the characteristics of metabolism of oxygen and its correlation with clinical manifestations in Severe Acute Respiratory Syndrome.Retrospective study was designed.Blood gas in88patients was detected up to213times.It was found that the decrease of PaO 2 was the most common(85.0%,181/213),the decrease of SaO 2 is the second(68.1%,145/213),and the in-crease of PaCO 2 is the least common(5.6%,12/213).All the data indicated that the incidence of hy-poxemia was the most prevalent and the increase of carbon dioxide was the least in all these patients.Hy-poxemia,clinical typing and phase were correlated,and respiratory alkalosis was widespread.In patients who died of SARS,there were not only respiratory alkalosis but also compound disorder of blood gas.The variation of metabolism of oxygen is the decrease of PaO 2 in the initial stage and overventilation ex-cited by hypoxemia.At the same time the decrease of PaCO 2 causes respiratory alkalosis,and the devel-opment of compound disorder of blood gas.Correlation exists between hypoxemia,clinical condition and prognosis,indicating that the treatment of oxygen in the initial stage is important.