烧伤患者三重酸碱平衡紊乱124例回顾性分析

Clinical characters and treatments of triple acid-base disorders in 124 cases with burn A retros-pective analysis

目的探讨烧伤患者三重酸碱平衡紊乱的临床特征与治疗方法。方法回顾性分析我科自1998-01～2004-04发生三重酸碱平衡紊乱的烧伤患者124例,其中呼碱+代酸+代碱85例,呼酸+代酸+代碱39例。所有患者均予祛除原发失衡病因、根据血pH情况补酸补碱、限碱、纠正电解质紊乱等治疗。结果复查血气分析纠正率89.5%,死亡率9.7%。结论休克、吸入性损伤、脓毒症是烧伤患者发生三重酸碱失衡的主要原因。临床以呼碱型三重酸碱失衡多见,呼酸型三重酸碱失衡则大多伴有吸入性损伤。烧伤合并三重酸碱失衡往往缺乏典型临床表现,死亡率较低。及时祛除引起原发失衡的病因是治疗的关键。

Objective To discuss the clinical characters and treatments of triple acid-base disorders(TABD) of burn patients(124 cases). Method The 124 patients with burn of our department from January, 1998 to April, 2004 who had triple acid-base disorders was reviewed. All the patients were treated with getting rid of original unbalance,adding acid or alkali based on blood pH,limiting the alkali input and correcting electrolyte turbulence.Result The blood gas turbulence correcting rate was 89.5% and the mortality rate was 9.7%.Conclusion Shock, inhalation injury and sepsis are the most important causations of triple acid-base disorders in burn patients. The respiratory alkalosis type of TABD was more common than the respiratory acidosis type and the latter usually accompanied with inhalation injury.Triple acid-base disorders are lack of typical clinical characters and have a low mortality rate in burn patients. Getting rid of original unbalance in time was the key of its therapy.