危重病人的碱中毒——附286例分析

An clinical analysis of alkalosis in 286 critically ill patients

本文分析了286例共511例次危重病人的动脉血气及电解质结果,表明:(1)危重病人碱中毒是常见的,其中代碱最常见,其它依次为呼碱,呼碱并代碱及呼碱型三重酸碱失衡。(2)碱中毒原因很多,原发疾病常引起呼碱;而代碱大部分是医源性引起的,特别是过多的NaHCO_3输入是主要原因。(3)呼碱性三重性酸碱失衡常见于多脏器损害的危重病人,其病死率为57.53％。

The parameters of 511 determinations of arterial blood gases and electrolytes in 286 critically ill patients were analyzed.The findings were as follows;(1)Alkalosis occurred frequently in critically ill patients.The most common form was metabolic alkalosis,and respiratory alkalosis,the combination of respiratory and metabolic alkalosis.and triple acid-base disorder with respiratory alkalosis were also common to be encountered.(2)The mechanism responsible for the occurrence of alkalosis was multifactorial.As a rule,the primary disease could result in respiratory alkalosis,and improper management especially excessive administration of sodium bicarbonate was responsible for the occurrence of metabolic alkalosis in most of the cases.(3)Triple acid-base disorder with respiratory alkalosis was frequently encountered in critically ill patients with functional impairment of multiple organs,whose prognosis was extremely grave with a mortality of 57.53%.