西宁地区肺原性心脏病酸碱失衡判断和呼吸衰竭血气诊断标准的探讨

AN EVALUATION OF THE ACID-BASE DISORDERS AND DIAGNOSTIC CRITERION OF RESPIRATORY FAILURE IN CHRONIC COR PULMONALE IN XINING

对西宁地区(海拔2260m)肺心病184例(276例次)作了血气和酸碱失衡分析。结果:(1)按平原酸碱失衡预计代偿公式判断,酸碱失衡和呼吸性酸中毒发生率低,代偿与失代偿呼吸性酸中毒比例小,呼吸性碱中毒比例高;将平原酸碱公式中的正常值改用西宁正常值判断,结果与平原资料接近。(2)按平原呼吸衰竭血气标准诊断,呼吸衰竭、Ⅰ型呼吸衰竭多,Ⅱ型呼吸衰竭少;用西宁呼吸衰竭血气标准诊断,呼吸衰竭、Ⅰ型呼吸衰竭少,Ⅱ型呼吸衰竭多。提出了当地肺心病酸碱失衡判断意见和呼吸衰竭血气诊断标准。

The blood gases and acid-base disorders were analysed in 276 cases with chronic cor pulmonale at 2260m above sea level (Xining). The results demonstrated that: (1) the incidence of acid-base disorders, respiratory acidosis and the ratio of compensatory to decompensatory respiratory acidosis were low, the rate of respiratory alkolosis was high, if they were evaluated according to the formula used on plains. If normal values determined in Xining were used, the various incidences were about the same as observed on plains. (2) In diagnosing respiratory failure with blood gas analysis if the criteria commonly employed on plains was applied, the incidence of type J respiratory failure was higher, and that of type I was lower. If PaO2<6.0 kPa and PaCO2>5.33kPa were used as the criteria for respiratory failue, the incidence of type I respiratory failure became lower with type Ⅱ higher. The characteristics of acid-base disorders and diagnostic criteria of respiratory failure in patients with cor pulmonale were discussed.