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目的 探讨新生儿重症监护室 (NICU)中新生儿血液酸碱失衡和阴离子间隙 (AG)的特点。方法 对NICU中 86例新生儿进行血气分析、血电解质测定及AG测定。应用单纯性酸碱失衡代偿预期公式判断混合性酸碱失衡。对AG和血气的关系进行t检验。结果 83例 ( 96 5 1% )存在酸碱紊乱 ,其中以代谢性酸中毒合并呼吸性酸中毒为最多见 ( 6 1 6 3% )。本组未见三重酸碱紊乱的病例。高AG4 9例 ( 5 6 98% ) ,为新生儿特点。AG与血气关系显示 ,高AG组与正常AG组的血液pH、氧分压 (PO2 )、氧饱和度 (SO2 )之间差异无显著性 (P >0 0 5 ) ,而与二氧化碳分压 (PCO2 )差异有显著性 (P <0 0 5 ) ,与剩余碱 (BE)、碳酸氢根 (HCO3 ) -差异有高度显著性 (P <0 0 1) 。结论 NICU中新生儿以代谢性酸中毒合并呼吸性酸中毒为最多见。危重新生儿存在高AG现象 ,对高AG酸中毒应以综合治疗
Objective To investigate the neonatal blood acid-base imbalance and anion gap (AG) in neonatal intensive care unit (NICU). Methods Blood samples were collected from 86 neonates in NICU, blood electrolytes and AG assay. Applying Simple Expected Compensation Formula of Acid - Base Imbalance to Judge Mixed Acid - Base Imbalance. T test was performed on the relationship between AG and blood gas. Results 83 cases (96 5 1%) had acid-base disorders, of which metabolic acidosis was the most common respiratory acidosis (6 1 6 3%). This group did not see the triple acid-base disorders. High AG4 9 cases (5698%), for the characteristics of newborns. The relationship between AG and blood gas showed no significant difference in blood pH, oxygen partial pressure (PO2) and oxygen saturation (SO2) between high AG group and normal AG group (P> 0.05) PCO2) was significantly different (P <0 05), with the remaining base (BE), bicarbonate (HCO3) - difference was highly significant (P <0.01). Conclusion NICU neonatal metabolic acidosis with respiratory acidosis is the most common. Critically ill neonates present with high AG and should be treated comprehensively with high AG acidosis