多器官衰竭合并混合性酸碱失衡

Multiple organ failure complicated by mixed acid-base disturbance

多器官衰竭（ＭＯＦ）并发混合性酸碱失衡８１例的２５１例次血气分析结果，显示１２８例次不能以动脉血气分析确诊。在该院混合性酸碱失衡最多见于肺原性心脏病合并右心衰竭和呼吸衰竭（５１８％）。多器官衰竭并发混合性酸碱失衡很常见（９４．２％）。呼酸型三重酸碱失衡和呼碱型三重酸碱失衡的病死率分别为４５．５％和６６．７％。电解质紊乱与混合世酸碱失衡密切相关。作者对混合性酸碱失衡的诊断和处理进行了讨论。为防止误诊，作者提出除血气分析外，需结合原发病、治疗措施、水和电解质变化、计算代偿预测公式和ＡＧ，作出综合分析；在防治措施方面作者强调了对ＭＯＦ的防治的重要性。

Blood gases were analyzed in 251 arterial bloodspecimens from 81 patients with multiple organ failure(MOF)complicated by mixed acid -base disturbances. The result showed that 128 diagnoses could not be con-firmed by aterial blood gas analysis。 Mixed acid-basedisturbances were mostly due to cor pulmonaie associatedwith respiratory failure and right heart failure(51.9%)in our hospital.Mixed acid-base disturbance complicat-ed by MOF was verv common(94.2%). The mortalityrate of triple acid-base disturbance(TABD)with respi-ratory acidosis and TABD with respiratory alkalosis was45.5%and 66.7%respectively, Electrolyte disorderswere closely correlated with mixed acid-base distur-bances. The diagnosis and management of mixed acid-base dist urbances were disLussed.