肺性脑病并发消化道出血对血气分析的影响  

The influence of digestive tract hemorrhage associated with pulmonary encephalopathy on blood gas analysis

作　　者：罗维贵[1] 许建国[1] 邓凌波[1] 许杰[1] 卢冬[1] 

机构地区：[1]右江民族医学院附属医院呼吸内科,广西百色533000

出　　处：《右江民族医学院学报》2004年第5期645-647,共3页Journal of Youjiang Medical University for Nationalities

摘　　要：目的探讨肺性脑病并发消化道出血对血气分析和电解质变化的影响。方法对33例肺性脑病并发消化道出血前后的血气分析和电解质指标进行比较。结果肺性脑病并发消化道大出血后,PaCO2、BE、HCO-3、K+、阴离子间隙升高;pH、PaO2、Na+、Ca2+、Cl-降低,与出血前比较差异有显著性(P均<0.05)。结论肺性脑病并发消化道大出血后酸碱失衡以呼吸性酸中毒并代谢性酸中毒占首位,呼吸性酸中毒并代谢性碱中毒位居第二,其他依次为呼吸性酸中毒、呼吸性碱中毒、代谢性碱中毒。电解质呈高钾低氯为主的改变,认识并纠正上述变化有助于降低病死率,提高生存率。Objective To study the influence of digestive tract hemorrhage associated with pulmonary encephalopathy on blood gas analysis and electrolyte changes. Methods Make a comparison to the blood gas analysis results and electrolyte index before and after bleeding in 33 patients with digestive tract hemorrhage associated with pulmonary encephalophy. Results After the massive hemorrhage of digestive tract associated with pulmonary encephalopathy, the PaCO 2, BE, HCO - 3, K +, anions gaps are increased, but pH, PaO 2, Na +, Ca 2+ and CL - are decreased, the differences are statistically significant in comparison to those before bleeding (all P<0.05). Conclusion After the digestive tract hemorrhage in patients with pulmonary encephalopathy, the first acid-base disturbance is respiratory acidosis combined with metabolic acidosis, the second is respiratory acidosis combined with metabolic alkalosis, the other rank is respiratory acidosis, respiratory alkalosis, metabolic alkalosis. The main electrolyte disorder is hyperkalemia, hyponatremia and hypochloremia. The understanding and management for the changes of acid-base and electrolyte is a great help for the decline of the mortality and the increasing of survival rate.

关 键 词：肺性脑病 消化道出血 血气分析 呼吸性酸中毒 并发 消化道大出血 代谢性碱中毒 首位 纠正 

分 类 号：R541.5[医药卫生—心血管疾病] R747.9[医药卫生—内科学]