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目的 分析重症肺结核继发感染的酸碱失衡情况。方法 以ABL-505血气电解质分析仪测定患者股动脉血,所得pH、PCO2、HCO-3值代入酸碱失衡预计代偿公式,首先判断出单纯型或混合型酸碱失衡,然后根据阴离子间隙判断有无三重酸碱失衡。结果 酸碱失衡发生率,单纯型>混合型>三重酸碱失衡;呼酸型>呼碱型,代酸与代碱基本相当;通过控制感染,酸碱失衡得到明显纠正。结论 重症肺结核继发感染可使肺组织严重破坏,通气与换气功能障碍,通气/血流比例失调,造成机体酸碱失衡。控制感染是治疗的关键,补充酸、碱性液体及纠正电解质紊乱是主要方法。确保机体内环境的稳定性及重要器官的供血供氧,防止出现多脏器功能衰竭。
Objective To analyze the acid-base imbalance in secondary infection of severe pulmonary tuberculosis. Methods The ABL-505 blood gas electrolyte analyzer was used to determine the femoral artery blood pressure. The obtained pH, PCO2 and HCO-3 values were substituted into the expected compensation formula of acid-base imbalance. The simplex or mixed acid-base imbalance was first determined and then judged according to the anion gap With or without triple acid-base imbalance. Results The incidence of acid-base imbalance, simple type> mixed type> triple acid-base imbalance; aconite type> exhaled type, substituting acid and base generation are basically the same; by controlling infection, acid-base imbalance was significantly corrected. Conclusion Severe pulmonary tuberculosis secondary infection can cause serious damage to lung tissue, ventilation and ventilation dysfunction, ventilation / blood flow imbalance, resulting in the body acid-base imbalance. Control of infection is the key to treatment, acid, alkaline fluids and electrolyte imbalance correction is the main method. To ensure the stability of the body environment and vital organs of oxygen supply to prevent multiple organ failure.