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目的探讨慢性重型肝炎患者血气特点及可能原因。方法用微量血气分析仪测定慢性重型肝炎126例患者动脉血气参数,用静脉血同步测定血钾、血钠、血氯和血尿素氮、血肌酐。先用Kassirer公式初步判断单纯或混合酸碱失衡(ABD),再按各型酸碱失衡预计代偿公式计算,同时计算阴离子隙(AG)值和潜在碳酸氢根(PB),判断多重酸碱失衡。结果126例次血气分析中,发生酸碱失衡115例次(91.3％)。其中呼吸性碱中毒合并代谢性碱中毒发生率最高,占31．7％;其次为呼碱合并代酸(25．4％)及单纯呼碱(22．2％)。三重酸碱失衡也以呼碱型TABD为主。肝硬化基础慢重肝与慢性肝炎基础慢重肝患者发生单纯酸碱失衡分别为31．4％、22．5％,发生多重酸碱失衡为65．1％、57．5％,两者相比,无显著性差异。本组共发生低氧血症34例次,占27．0％。pH<7．35的患者均出现在死亡组。结论慢性重型肝炎患者的酸碱失衡以碱血症为主,呼吸性碱中毒为基本酸碱失衡类型。酸碱失衡与发生慢重肝的基础病变无关。慢重肝患者较易出现轻度低氧血症。血pH值降低是慢重肝死亡的重要因素。
Objective To investigate the characteristics and possible causes of blood gas in patients with chronic severe hepatitis. Methods The arterial blood gas parameters of 126 patients with chronic severe hepatitis were determined by micro blood gas analyzer. Serum potassium, serum sodium, blood chlorine, blood urea nitrogen and serum creatinine were simultaneously measured by venous blood. First, Kassirer formula was used to determine simple or mixed acid-base imbalance (ABD), and then calculate the expected compensation formula for each type of acid-base imbalance. Simultaneously calculate the anion gap (AG) value and potential bicarbonate (PB) Imbalance Results 126 cases of blood gas analysis, acid-base imbalance occurred in 115 cases (91.3%). Respiratory alkalosis and metabolic alkalosis were the most common, accounting for 31.7%; followed by alkalosis with acid (25.4%) and simple alkali (22.2%). Triple acid-base imbalance also called alkaline base TABD. The basic acid-base imbalance of patients with chronic liver cirrhosis and severe chronic hepatitis based on chronic basic hepatitis were 31.4% and 22.5%, respectively, and multiple acid-base imbalances occurred in 65.1% and 57.5% No significant difference. This group occurred a total of 34 cases of hypoxemia, accounting for 27.0%. Patients with a pH <7.35 appeared in the death group. Conclusion Acid-base imbalance in patients with chronic severe hepatitis is mainly akinemia, and respiratory alkalosis is the basic type of acid-base imbalance. Acid-base imbalance has nothing to do with the occurrence of chronic severe liver disease. Patients with chronic severe mild hypoxemia. Lower blood pH is an important factor in the death of chronic severe liver.