呼吸性酸中毒合并代谢性碱中毒(以下简称呼酸合并代碱)是肺心病治疗过程中常见的一种酸碱平衡失常,预后十分严重,据国内资料统计,死亡率一般为50～60％,藤田报告60例,死亡34例(56.7％),而无碱中毒的268例高碳酸血症病人,只死亡78例(29.1％),本文就有关资料列举本院病例,对肺心病呼酸合并代碱的发病机理与诱因,临床表现,诊断,治疗及预防等问题综述如下,以供临床专业工作者参考。 一、呼酸合并代碱的机理与诱因 重症肺心病患者多数伴有二氧化碳潴留而可导致血液酸碱度的下降,一般慢性肺心病患者由于肾脏的代偿,血浆碳酸氢根浓度亦相应增高,故虽有二氧化碳潴留,其酸碱度仍可维持在正常范围或稍低于正常,Culeria指出:动脉血二氧化碳分压与碳碱氢根浓度在慢性高碳酸血症中具有明显的正 Respiratory acidosis with metabolic alkalosis (hereinafter referred to as acid combined with alkali) is a common treatment of pulmonary heart disease acid-base balance disorders, the prognosis is very serious, according to domestic statistics, the mortality rate is generally 50 to 60% , Fujita reported 60 cases, 34 patients died (56.7%), while no alkalosis in 268 cases of hypercapnia patients, only 78 patients died (29.1%), this article lists the hospital cases of phonocardiosis The combined generation of alkali pathogenesis and incentives, clinical manifestations, diagnosis, treatment and prevention and other issues are summarized below, for clinical professional workers for reference. First, the mechanism and causes of acidosis combined with alkali alkali Most patients with severe pulmonary heart disease associated with carbon dioxide retention can lead to decreased blood pH, the general chronic pulmonary heart disease due to kidney compensation, plasma bicarbonate concentration also increased, so although There is carbon dioxide retention, the pH can still be maintained within the normal range or slightly below normal, Culeria pointed out: arterial carbon dioxide partial pressure and carbon-hydrogen concentration in chronic hypercapnia has a significant positive