危重病三重酸碱失衡发生率及预后分析  

Incidence and Prognosis of Triple Acid-base Disturbance in Patients with Critical Illness

作　　者：邹玉刚[1] 梁显泉[2] 

机构地区：[1]遵义医学院第三附属医院急诊科,贵州遵义563002 [2]贵阳医学院附院急诊科,贵州贵阳550004

出　　处：《贵阳医学院学报》2011年第4期362-365,共4页Journal of Guiyang Medical College

摘　　要：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（P0.01）.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（P0.01）.The APACHE Ⅱ scores of TABD patients were significantly higher than those of normal patients（P0.01） and simple ABD patients（P0.01）,but there was no significant difference between DABD patients and TABD patients（P0.05）.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：危重病 酸碱平衡失调 血气分析 

分 类 号：R364.8[医药卫生—病理学]