肝性脑病患者酸碱及电解质监测的临床意义  

Clinical significance of monitoring acid-base,blood gas and electrolyte in patients with hepatic encephalopathy

作　　者：胡小丽[1] 邓茂林[1] 岳光平[1] 蒋永威[1] 

机构地区：[1]成都铁路中心医院消化内科,四川成都610081

出　　处：《实用医院临床杂志》2008年第5期51-52,共2页Practical Journal of Clinical Medicine

摘　　要：目的探讨肝硬化患者并发肝性脑病(HE)时的酸碱、电解质变化及其临床意义。方法81例肝硬化并发肝性脑病患者行动脉血气分析,同时检测血清Na+、K+、Cl-水平。结果81例患者均有酸碱失衡,其中25例伴呼吸性碱中毒(30.9%),53例电解质紊乱(65.4%),以低钠血症、低钾血症常见;41例肝功能C级患者中有28例为复合酸碱失衡(68.3%),与肝功能A级患者比较,差异有显著性意义(P<0.05)。结论肝性脑病患者以单纯呼吸性碱中毒最常见,肝功能C级患者更易合并复合酸碱失衡。及时对这些指标进行检测,有助于对患者进行及时诊治,改善预后。Objective To evaluate the clinical significance of acid-base, blood gas and electrolyte disturbance and their relationship in patients with hepatic encephalopathy （ HE）. Methods From January 2004 to December 2007,81 patients with hepatic encephalopathy were studied. Arterial blood gas analysis and serum electrolyte were determined. Results All the 81 patients had disturbance of acid-base balance, in whom 25 patients had respiratory alkalosis （ 30. 9% ） , and 53 electrolyte disturbance （65.4%）. The incidence of hyponatremia and hypokalemia were high. Among the 41 Child-Puph C cases, 28 had compound acid-base disturbance （ 68.3% ）. There was significant difference when compared with those of Child-Puph A （ P 〈 0. 05 ）. Conclusion Patients with hepatic encephalopathy tend to complicate acid-base, blood gas and electrolyte disturbance. Among acid-base disturbance cases, the incidence of simple respiratory alkalosis is the highest. Compound acid-base disturbance often occurs in advanced Child-Puph C patients. Monitoring these parameters in time is helpful for the diagnosis, therapy, and prognosis of the patients.

关 键 词：肝性脑病 酸碱失衡 血气分析 电解质 

分 类 号：R747.9[医药卫生—神经病学与精神病学]