慢性阻塞性肺疾病伴意识障碍病情程度与患者动脉血气参数关系的临床研究  

Clinical study of relationship between severity and arterial blood gas parameters in patients with COPD merging conscious disturbance

作　　者：洪原城[1] 黄种杰[1] 黄鑫成[1] 范洪涛[1] 

机构地区：[1]中国人民解放军第180医院呼吸内科,福建泉州362000

出　　处：《临床肺科杂志》2015年第3期453-455,共3页Journal of Clinical Pulmonary Medicine

基　　金：福建省泉州市社会发展计划重点项目(No 2012z58)

摘　　要：目的探讨慢性阻塞性肺疾病(简称慢阻肺)伴意识障碍患者的病情程度与动脉血气参数之间的关系。方法 90例慢阻肺患者根据意识障碍程度分为清醒组、嗜睡组和昏迷组,对照组为30例健康体检者。分别测定各组患者及对照组的动脉血气指标及电解质。结果与对照组相比,慢阻肺患者p H值、动脉氧分压(Pa O2)、血氧饱和度(Sa O2)及氧合指数显著下降(P<0.05),二氧化碳分压(Pa CO2)、碳酸氢盐(HCO-3)则显著升高(P<0.05),且出现Na+、CL-、K+降低(P<0.05);随着意识障碍程度加重,清醒组、嗜睡组和昏迷组Pa CO2、HCO-递增,p H值、Pa O2及Sa O2及氧合指数递减,Na+、CL-、K+也呈递减水平(P<0.05)。结论动脉血气参数变化可以反映慢阻肺患者意识障碍程度,随着动脉血气酸碱平衡紊乱加重,患者意识障碍程度加深。Objective To investigate the relationship between severity and arterial blood gas parameters in patients with COPD merging conscious disturbance. Methods According to various degree of conscious disturbance, 90 patients with COPD were divided into the awake group, the somnolent group and the stuporous group. Another 30 healthy people were taken as the control group. The indexes of arterial blood gas and electrolyte in COPD patients and the control group were determined. Results Compared with the control group, the value of pH, PaO2 , SaO2 and ox-ygenation index decreased significantly in COPD patients （ P〈0. 05 ） , while the levels of PaCO2 and HCO3 - in-creased significantly （P〈0. 05）. At the same time, there was a low level of Na＋, CL- and K＋ in COPD patients （P〈0. 05）. As anemia worsened, the levels of PaCO2 and HCO3 - were incremental, but the value of pH, PaO2, SaO2 and oxygenation index were diminishing in the awake group, the somnolent group and the stuporous group （ P〈0. 05）. And the levels of Na＋, CL- and K＋ decreased gradually （P〈0. 05）. Conclusion The change of arterial blood gas parameter can reflect the degree of conscious disturbance in COPD patients. With the development of arteri-al blood gas acid-base balance disorders increases, the degree of disturbance of consciousness deepens.

关 键 词：慢性阻塞性肺疾病 意识障碍 动脉血气参数 

分 类 号：R563.9[医药卫生—呼吸系统]