高原地区严重创伤患者动脉血气指标监测分析

Analysis the blood gas of serious trauma patients in plateau

目的:监测高原地区严重创伤患者酸碱及氧合指标特点。方法:入选2011年1月—2013年7月来我院急诊科就诊的创伤患者90例(ISS≥16分)。监测动脉血气指标:pH值、动脉血氧分压(PaO_(2))、动脉血CO_(2)分压(PaCO_(2))、实际碳酸氢盐(AB)、动脉血氧饱和度(SaO_(2))、肺泡-动脉氧分压差[P(A-a)O_(2))]变化特点。结果:pH值7.44±0.01;PaO_(2)(61.92±1.57)mmHg;PaCO_(2)(28.00±0.82)mmHg;AB(19.06±0.31)mmol/L;SaO_(2)(%)89.27±1.22;P(A-a)O_(2)(48.10±1.52)mmHg。高原地区严重创伤后酸碱及氧合各指标与平原地区对比所有酸碱及氧合指标总体均数估计值(除pH值外),差异显著(P<0.05)。结论:高原地区严重创伤发生后,所有患者均存在不同程度的低氧血症及换气功能障碍,酸碱类型特点是以pH值正常范围的呼吸性碱中毒及以AB降低为主的代偿性代谢性酸中毒。

Objective:To monitor the index characters of acid-base and oxidation of serious trauma patients in plateau.Methods:90 trauma patients(ISS≥16)were treated in emergence department since Jan 2011 to July 2013,and pH,PaO_(2),PaCO_(2),AB,SaO_(2),P(A-a)O_(2)were immediately monitored just as they were hospitalized.Results:pH 7.44±0.01,PaO_(2)(mmHg)61.92±1.57,PaCO_(2)(mmHg)28.00±0.82,AB(mmol/L)19.06±0.31,SaO_(2)(%)89.27±1.22,P(A-a)O_(2)(mmHg)48.10±1.52.Except the PH,the total averages of acid-base and oxidation of the serious trauma patients had statistic differences from those of the plain(P<0.05).Conclusion:In plateau,the serious trauma patients were encountered different hypoxemia and dysfunction of gas exchange,the style of acid-base were characterized of respiratory alkalosis with normal PH and compensatory metabolic acidosis with decreased AB.