肝肾综合征并发电解质和酸碱失衡的临床研究

Study of electrolytes and Acid-base Disorders in Patients with Hepatorenal Syndrome

目的:探讨肝肾综合征患者电解质和酸碱平衡紊乱的发生规律及特点。方法:对1996年至2 0 0 4年间76例肝肾综合征患者的电解质、血浆渗透压和动脉血气分析等检测结果进行回顾性分析。结果:肝肾综合征患者中单纯酸碱失衡19例(2 5 .0 % ) ,二重酸碱失衡4 0例(5 2 .6 % ) ,三重酸碱失衡16例(2 1.1% ) ;电解质紊乱一般表现为低钠血症(10 0 .0 % ) ,低氯血症占2 5 .0 %。低钾血症占11.8% ,高钾血症占9.2 % ,血浆渗透压降低占86 .8%。结论:肝肾综合征患者经常出现电解质和酸碱平衡紊乱,并且使其病情更趋复杂化,电解质和酸碱失衡反映病情严重程度,对患者的预后与转归有很好的提示作用。

Objective To investigate the law and peculiarity of the electrolytes and acid-base disorders in patients with hepatorenal syndrome.Methods The serum electrolytes parameter,arterial blood gases and plasma osmotic pressure of 76 cases which had hepatorennal syndrome were investigated retrospectively.Results There were 19 cases with single acid-base disorders(25.0 %), 40 cases with doubleacid-base disorders(52.6 %),and 16 cases with triple acid-basedisorders(21.1 %);The electrolytesusually manifested hyponatremia(100.0 %),hypochloremia(25.0 %),hypokalemia(11.8 %), hyperkalemia(9.2 %) and low osmotc pressure of plasma(86.8 %) were often seen in the patients with hepatorenal syndrome.Conclusion Electrolytes and acid-base disorder are very Common in the patients with hepatorenal syndrome and this will make the condition worse.The disordes of electrolytes and acid-base consistently reflects severity of hepatorenal syndrome,it is an important predictor of the prognosis.