慢性阻塞性肺疾病与三重酸碱失衡

Chronic Obstructive Pulmonary Disease and the Triple Acid-base Disorder

本文报告280例伴有酸碱失衡的慢性阻塞性肺疾病患者中,诊断三重酸碱失衡17例(6%),均为呼酸型三重酸碱失衡,其AG值均>20mmol/L,潜在HCO_3^-均>30mmol/L,诱发因素以低氧血症、热量摄入不足、用药不当占多数,死亡率高达41.2%,应引起临床医师高度重视。三重酸碱失衡的处理必需十分慎重,在治疗基础疾病和诱因的同时,还需注意电解质、营养及正确使用呼吸机等。

of 280 patients with chronic obstructive pulmonary disease associated with acid-base imbalance, 17 (6%) had triple acid-base disorder of the respiratory acid type, in whom the median anion gap was over 20 mmol/L, and the potential bicarbonate over 30mmol/L. Contributing factors may include hypoxemia, insufficient intake of calories and improper use of drugs. The mortality of the disorder was as high as 41.2 percent, alerting the clinicians to the graveness of the disorder. In addition to treatment of the underlying disease and contributing factors, serum electrolytes, general nutrition and proper use of respirator should also be considered in the management of the disorder.