急性脑卒中67例血气变化及酸碱平衡临床分析  

Clinical Analysis of Blood-gas Changes and Acid-base Balance in 67Cases of Acute Stroke Patient

作　　者：刘海燕[1] 蒲传强[2] 赵沂敏[3] 

机构地区：[1]北京海淀医院神经内科,100080 [2]解放军总医院神经内科 [3]中国康复研究中心神经内科

出　　处：《医学理论与实践》1999年第1期21-23,共3页The Journal of Medical Theory and Practice

摘　　要：为探讨急性脑卒中后血气及酸碱平衡变化.本文选择了经头颅CT证实的脑出血。蛛网膜下出血(SAH)及脑梗塞患者67侧,于发病后24—48小时进行血气分析.发现脑出血>30ml和出血破入脑室。SAH及大面积脑梗塞患者中60％为呼碱并代酸及呼碱型三重碱失衡(TADD),还发现混合性酸碱失衡死亡率比单纯性的和正常血气要高(P<0.05).生存组与死亡组PaCO_2和HCO_3值比较有显著性差异(P<0.05),提示酸碱失衡的严重程度同血管性病的性质和大小及预后有较大关系,PaCO_2降低程度与HCO_3值和死亡率呈正相关.To study the Change of blood-gas and acid-base balanoe in 67 acute stroke patients, which inc luded cerebral hemorrhage(32 cases), subarachnoid hemorrhage(3 cases)and cerebral infarction(32 cases), that confirmed by CT scan. We observed that 60% of cerebral hemorrhage (volume>30ml), blood broken into ventricle, SAH and large cerebral infarction patients were acid-base unbalance from blood-gas analysis 24 to 48 hours after stroke. Main three kinds of acid-base unbalance were respiratory alkalosis and metabolic acidosis. the second were metabolic acidosis and the third were respiratory alkalosis and metabolic acidosis or metabolic acidosis and metabolic alkalosis. In addition, the mortali-ty of variegated acid-base unbalance is higher than that of only one kind of acid-base unbalance or normal range of blood-gas examination(p<0.05).There is sign ificant difference of PaCO2 and HCO3between survival group and death group. It shows they have important relation between the severity of acidbase unbalance and the character and size of v asular disease. It also shows they are positive relationship between the descent of PaCO2 and value of HCO3-and mortality.

关 键 词：脑卒中 血气分析 酸碱平衡失调 

分 类 号：R743.3[医药卫生—神经病学与精神病学]