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肝性脑病呼吸性碱中毒并发混合型酸碱失衡的诊断 被引量:2

Diagnosis of respiratory alkalosis compllcated bymixed acld-base disturbance in hepatic encephalopathy
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摘要 169例肝性脑病498例次动脉血气和血电解质研究结果表明,运用呼碱和代碱预计代偿公式,可对肝性脑病呼碱并发混合型酸碱失衡作出正确的判断。凡符合实例正常可判断为呼碱并代酸;实测正常,可判断为呼碱并代碱;呼碱伴AG升高,实测正常,可判断为呼碱型三重酸碱失衡。呼碱PaCO_2<4.67kPa时,机体尽管发挥了最大的代偿能力,也不能使pH恢复正常。酸碱失衡预计代偿公式能对不同PaCO_2水平提供不同的判断结果。公式计算简单,便于临床应用。 The parameters of 498 arterial blood gas andeleclrolyte measurements in 169 patients with hepaticencephalopathy were analyzed.Theresult showedthat correct diagnosis of respiratory alkalosis associ-ated with mixed acid-base disturbance in hepaticencephalopathy could be made with the use ofpreestimated compensatory formulas (PCF) forrespiratory and metobolic alkalosis.if the actualHCO_3is< normal HCO_3+0.5×△ PaCO_2-2.5,respiratory alkalosis complieated by metabolicacidosls can be diagnosed.If the actual HCO_3 iS>normal HCO_3+0.5×△PaCO_2+2. 5,respiraloryalkalosis with metabolic alkalosis can be dlagnosed.Ifrespiralory alkalosis is associated with elevated aniongap (A and the actual HCO_3+△AG is >normalHCO_3+0.5×△ PaCO_2+2.5,triple acid-base disturb-ance can be diagnosed.Irrcspective of maximal com-pensalion of the body, pH cannot relurn to normalwhen respiratory alkalosis is associated with aPaCO_2less than 4.67kPa.The PCF of acid-base canprovide different results to different PaCO_2levels,and is simple and convenient for clinical use.
出处 《中国危重病急救医学》 CAS CSCD 1994年第1期23-26,共4页 Chinese Critical Care Medicine
关键词 肝性脑病 碱中毒 酸碱代谢紊乱 hepatic encephalopathy alkalosis respiratory acid-base disturbance preestimatedcompensatory formula
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