邹玉刚,梁显泉
ZOU Yugang,LIANG Xianquan (Department of Emergency

• 1:遵义医学院第三附属医院急诊科
• 2:贵阳医学院附院急诊科

摘要(Abstract)：

目的:了解危重病三重酸碱失衡(TABD)发生率及预后。方法:选择392例危重病患者为研究对象,检测其动脉血气分析值和血电解质,计算阴离子间隙、潜在HCO3-,根据酸碱失衡诊断标准,了解TABD的发生率,并分析其预后情况。结果:392例危重患者中TABD 42例(10.7%),≥60岁TABD发生率较高,TABD组年龄显著高于非TABD组(P<0.01)。TABD组中,多器官功能障碍综合征(MODS)发生率(10例,23.8%)高于正常组(2例,6.3%,P<0.01)、单纯ABD组(11例,6.8%,P<0.01)和DABD组(13例,8.7%,P<0.01)。TABD组急性生理及慢性健康状态评分(APACHEⅡ评分)的明显高于正常组(19.1±7.92)、单纯ABD组的(22.5±7.43)%,P<0.01;与DABD组无明显差异(24.8±5.35,P>0.05)。TABD组死亡率(10例,61.1%)明显高于正常组(2例,11.9%,P<0.01)、单纯ABD组(11例,35.5%,P<0.01)和DABD组(13例,45.3%,P<0.01)。结论:危重病TABD发生率较高,其发生与年龄、原发病、APACHEII评分有关,与预后有相关性。
Objective:To investigate the incidence and prognosis of triple acid-base disturbance(TABD) in patients with critical illness.Methods:Three hundreds and ninety two critical patients were selected as study subjects.Arterial blood gas analysis was carried out and blood electrolytes were tested,anion gap(AG) and potential HCO3-were calculated.Acid-base disturbance(ABD) was diagnosed according to the diagnostic standards.The incidence of TABD was investigated,and the prognosis was analyzed.Results:The incidence of TABD was 10.7%(42 /392) and was higher in patients aged 60 or above.The age of TABD patients was elder than that of non-TABD patients(P<0.01).The incidence of multiple organ dysfunction syndrome(MODS) and mortality in TABD patients were higher than those of normal,simple ABD and duplex ABD(DABD) patients(P<0.01).The APACHE Ⅱ scores of TABD patients were significantly higher than those of normal patients(P<0.01) and simple ABD patients(P<0.01),but there was no significant difference between DABD patients and TABD patients(P>0.05).Conclusions:The incidence of TABD is comparatively high in critical patients.It is correlated with age,APACHE Ⅱ scores,primary disease,and prognosis.

关键词(KeyWords)： 危重病;酸碱平衡失调;血气分析
critical illness;acid-base inbalance;blood gas analysis

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 邹玉刚,梁显泉
ZOU Yugang,LIANG Xianquan (Department of Emergency

DOI: 10.19367/j.cnki.1000-2707.2011.04.011

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