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目的:探讨慢性肺源性心脏病(肺心病)急性加重期三重酸碱失衡血气和电解质变化,分析原因并制定防治措施。方法:250例慢性肺心病患者合并三重酸碱失衡者28例,对28例患者的血气和电解质指标,包括pH值、动脉血二氧化碳分压(PaCO2)、碳酸氢根离子(HCO3-)、钠离子(Na+)、氯离子(Cl-)浓度进行测定,并与32例血气分析结果正常者进行比较,观察各项指标变化情况。结果:28例三重酸碱失衡患者中,20例为呼酸型三重酸碱失衡,与血气正常者相比,pH、Cl-浓度降低,PaCO2、HCO3-浓度升高。8例呼碱型三重酸碱失衡,与血气正常者相比,PaCO2及HCO3-、Cl-浓度降低,pH升高。结论:慢性肺心病急性加重期者常发生三重酸碱失衡,以呼酸型三重酸碱失衡为主。三重酸碱失衡的纠正是临床治疗成功与否的关键性因素之一。
Objective: To investigate the changes of blood gas and electrolyte in triple acid-base imbalance in acute exacerbation of chronic cor pulmonale (pulmonary heart disease), analyze the causes and make prevention and cure measures. Methods: Totally 28 patients with chronic cor pulmonale complicated with triple acid-base imbalance were enrolled in this study. Blood gas and electrolytes were measured in 28 patients, including pH, PaCO2, HCO3-, Ion (Na +) and chloride ion (Cl-) were measured and compared with 32 normal blood gas analysis results to observe the changes of various indicators. Results: Of the 28 patients with triple acid-base imbalance, 20 were acid-base triple-acid-base imbalances. Compared with those with normal blood gas, the pH and Cl- concentrations decreased and the concentrations of PaCO2 and HCO3- increased. 8 cases of alkaloid triple acid-base imbalance, compared with normal blood gas, PaCO2 and HCO3-, Cl- concentration decreased, pH increased. Conclusion: The triple acid-base imbalance often occurs in patients with acute exacerbation of chronic pulmonary heart disease. Triple acid-base imbalance correction is one of the key factors in the success of clinical treatment.