脑卒中病人血气变化的探讨

Discussion of the blood gas changes in patients with stroke

目的 :探讨脑卒中患者酸碱失衡的类型、原因与救治原则。方法 :对 134例经CT确诊的急诊或住院的脑卒中患者进行动脉血气分析 ,并在同一天抽取静脉血测血Na+ 、Cl-浓度 ,所测数值均按各型酸碱失衡预计代偿公式计算。结果 :134例共进行 2 10例次动脉血气分析 ,不同类型不同程度的酸碱失衡共 14 8例次 (占 70 48% ) ,其中单纯性酸碱失衡 79例次 (占 37 6 2 % ) ,二重酸碱失衡 6 0例次 ( 2 8 5 7% ) ,三重酸碱失衡 9例次 ( 4 2 9% )。结论 :脑卒中患者存在酸碱失衡 ,以代谢性酸中毒、代谢性酸中毒合并呼吸性酸中毒、呼吸性碱中毒最为常见。原则上以治疗原发病为基础 ,纠正原发酸碱失衡 ,维持水电解质平衡 。

Objective To study types,causes and therapy for acid-base disturbance in patients with stroke.Methods Artery blood gas analysis was done 210 times in 134 inpatients and those treated in Emergency Department with stroke confirmed by CT,and meanwhile vein blood was drawn to determine Na + and Cl - concentrations.The results were calculated by various acid-base disturbance compensatory formulas.Results Of the 210 times artery blood gas analysis in 134 patients ,there were 148 times acid-base disturbance of different types with different degrees(70.48%),in which 79 times were unitary acid-base disturbance(37.62%),60 were dual acid-base disturbance(28.57%) and 9 were triple acid-base disturbance(4.29%).Conclusions It is common to see acid-base disturbance occurring in patients with stroke,especially metabolic acidosis,metabolic acidosis combined with respiratory acidosis,and respiratory alkalosis.The therapy should be based on the treatment of primary illness.Under the prerequisite of redress of primary disturbance,water-electrolyte balance should be maintained so as to reverse pH value to normal.