严重代谢性碱中毒时CO_2潴留的处理

Management for CO_2 retention after extreme metabolic alkalosis

代谢性碱中毒是指细胞外液碱增多和(或)H^+丢失引起血液pH升高,以血浆HCO_3^-原发性增多为特征,动脉血二氧化碳分压(PaCO_2)可代偿性增高,一般极少超过55 mmHg。然而,在极其严重代谢性碱中毒情况下,PaCO_2代偿极限可达60~72 mmHg,但目前国内外鲜有此类报道。本文探讨了我院成功抢救的1例严重代谢性碱中毒患者,以提高对该罕见临床现象的认识。

Metabolic alkalosis is a metabolic condition of increased alkaline substances in extracellular fluid and/or elevated pH due to loss of hydrogen ions （H＋）, and is characterized by an increase in plasma bicarbonate （HCO3-）.It may result in a compensatory elevation of arterial partial pressure of CO2 （PaCO2）, which is rarely greater than 55 mmHg.However, the upper limit of PaCO2 compensation can exceed 60 mmHg in severe metabolic alkalosis, though at present there are few such reports at home and abroad.In this article, we reported the successful rescue for a case of extreme metabolic alkalosis so as to raise the awareness of this rare clinical phenomenon.