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目的 :探讨COPDⅡ型呼吸衰竭机械通气并发代谢性碱中毒的病因和治疗、预防的方法 .方法 :6 2例COPD急性发作期Ⅱ型呼吸衰竭行机械通气持续 72h以上 ,其中 2 0例并发代谢性碱中毒 ,对该组病例通气前、后 2 4h ,4 8h ,72h进行血气及电解质测定并进行比较分析 .结果 :2 0例COPDⅡ型呼吸衰竭患者机械通气前有低钠、低氯存在 ,机械通气后CO2 排出过快 ,pH值升高 ,出现不同程度的兴奋、躁动等碱中毒症状 .结论 :CO2 排出过快及低钠、低氯是造成机械通气中代谢性碱中毒的原因 ,可容许高碳血酸症和及时补钠、氯是预防和治疗代谢性碱中毒的主要方法
Objective: To explore the etiology, treatment and prevention of mechanical ventilation complicated with metabolic alkalosis in COPD type Ⅱ respiratory failure.Methods: Sixty-two cases of type Ⅱ respiratory failure with acute exacerbation of COPD were treated for more than 72 hours, of which 20 cases were complicated with metabolic Alkali poisoning, blood gases and electrolytes were measured and compared at 24 hours, 48 hours and 72 hours before and after ventilation in this group.Results: Twenty patients with COPD type Ⅱ respiratory failure had low sodium and low chlorine before mechanical ventilation, while mechanical Ventilation after CO2 emission is too fast, pH value, there are different degrees of excitement, agitation and other symptoms of alkali poisoning.Conclusion: CO2 excretion and sodium, chlorine is the cause of metabolic alkalosis in mechanical ventilation may be tolerated Hypercapnia and timely sodium, chlorine is the prevention and treatment of metabolic alkalosis the main method