论文部分内容阅读
本文对33例肝性脑病进行了血气及酸硷失衡的观察。结果有呼吸性硷中毒者31例占93.9％。其中单纯型呼吸性硷中毒4例(12.12％),呼吸性硷中毒合并代谢性硷中毒18例(54.55％,)呼吸性硷中毒合并代谢性酸中毒3例(9.09％),呼吸性酸中毒合并代谢性酸中毒2例(6.06％),呼吸性硷中毒合并代谢性硷中毒合并代谢性酸中毒6例(18.18％)。血pH值>7.45者29例(87.87％)。本组资料说明肝性脑病的酸硷失衡主要是硷中毒。其发生机理:呼吸性硷中毒可能与低氧血症、高氨血症、血孕酮增高有关。代谢性硷中毒主要与低盐饮食、利尿剂及硷性药物的不适当应用有关。而代谢性酸中毒主要与严重并发症有关。硷中毒时血游离NH_3增高,且易透过血脑屏障导致昏迷。因此积极纠正硷中毒对肝性脑病的防治有非常重要的意义。治疗硷中毒的原则是去除病因、纠正过度通气、纠正电解质紊乱。补充盐酸精氨酸、氯化钾等有较好的疗效。
In this paper, 33 cases of hepatic encephalopathy were observed blood gas and acid-base imbalance. Results of respiratory alkalosis in 31 cases accounted for 93.9%. Among them, simple type respiratory alkalosis in 4 cases (12.12%), respiratory alkalosis combined with metabolic alkalosis in 18 cases (54.55%), respiratory alkalosis with metabolic acidosis in 3 cases (9.09%), respiratory acidosis Metabolic acidosis in 2 cases (6.06%), respiratory alkalosis with metabolic alkalosis in 6 cases (18.18%) with metabolic acidosis. Blood pH> 7.45 in 29 cases (87.87%). This group of data shows that acid-base imbalance of hepatic encephalopathy is mainly alkaline poisoning. The mechanism of occurrence: Respiratory alkalosis may be related to hypoxemia, hyperammonemia, increased blood progesterone. Metabolic alkalosis is mainly associated with inappropriate use of low-salt diet, diuretics and alkaloids. Metabolic acidosis is mainly associated with serious complications. Alkaline poisoning of blood free NH_3 increased, and easily lead through the blood-brain barrier coma. Therefore, the positive correction of alkalosis on the prevention and treatment of hepatic encephalopathy has very important significance. The principle of treatment of alkaline poisoning is to remove the cause, correct hyperventilation, correct electrolyte imbalance. Arginine hydrochloride, potassium chloride, etc. have a better effect.