50例重症肺结核合并呼吸衰竭动脉血气及电解质临床分析

Arterial blood gas and electrolytes in severe pulmonary tuberculosis with respiratory failure: analysis of 50 cases

目的探讨重症肺结核并呼吸衰竭动脉血气及电解质分析特点。方法检测50例重症肺结核患者呼吸衰竭发生后的首次动脉血气及电解质,判断呼吸衰竭及酸碱失衡类型。结果重症肺结核并呼吸衰竭以低氧血症为特点,同时可伴有不同程度的高碳酸血症;重症肺结核病变范围越宽、病程越长越易出现Ⅱ型呼吸衰竭;阴离子间隙(AG)值增高者在正常或异常pH范围内均可出现。结论重症肺结核首次动脉血气及电解质分析能帮助监测病情、指导治疗、判断预后。

Objective To study the characteristics of arterial blood gas and electrolytes in patients with severe pulmonary tuberculosis with respiratory failure. Method In 50 patients with severe pulmonary tuberculosis, the arterial blood gas and electrolytes were measured after the onset of respiratory failure to define the types of respiratory failure and acid-base imbalance. Results Severe pulmonary tuberculosis with respiratory failure was characterized by development of hypoxia, and the degree of hypercapnia may vary; more extensive tuberculous involvement or longer disease course suggest greater chance of type Ⅱrespiratory failure. Increment of the anion gap occurred irrespective of the pH value. Conclusion Analysis of arterial blood gas and electrolytes may help monitor the progression of severe pulmonary tuberculosis and provides valuable information for implementing treatment and making prognostic decisions.