血液透析救治尿毒症伴严重酸中毒的疗效观察

Observation on the Effect of Hemodialysis in Treatment of Uremic Patients Complicated With Severe Acidosis

目的 :观察血液透析抢救尿毒症伴严重代谢性酸中毒的疗效。方法 :对血 pH值 <7.0的尿毒症患者 36例采用碳酸盐血液透析 ,透析前给予补充钙剂 ,对存在呼吸障碍者给予气管插管呼吸机辅助呼吸。结果 :患者行血液透析 1h后血pH值及HCO-3 开始上升 ,血钾逐渐下降 ,透析结束时各值均达到基本正常范围。结论 :血液透析能够迅速纠正尿毒症患者严重代谢性酸中毒及高钾血症。

Objective:To investigate the effect of hemodialysis for uremic patients complicated with severe metabolic acidosis. Methods: Bicarbonate hemodialysis was applied for 36 uremic patients with acidosis (pH< 7.0). Calcium was supplied before hemodialysis. Endotracheal intubation was applied in patients with respiratory distress. Results: Plasma pH and concentration of bicarbonate (HCO - 3) began to rise; PCO 2 and serum potassium concentration gradually decreased 1 hour after hemodialysis. Plasma pH, PCO 2 and serum potassium reached normal level at the end of hemodialysis.Conclusion:Hemodialysis may correct severe metabolic acidosis and hyperkalemia in uremic patients rapidly, but endotracheal intubation should be applied early in patients with respiratory distress.