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本文报道43例危重病员89例次动脉血气测定及抢救酸碱失衡危重病员的体会。认为对急、慢性呼吸性酸中毒的处理原则主要是积极改善通气,使原发升高的PaCO_2下降,绝对不能盲目补碱,当pH<7.20时,一次补5％碳酸氢钠以40ml为宜。对急慢性呼酸并代碱的处理原则是一定要同时处理两种原发失衡,即积极改善通气并适量补碱,补碱量宜比单纯呼酸者稍大。处理碱中毒的原则是从治疗极原发失衡着手,尽快使pH恢复正常,切不可误为代酸而盲目补碱,碱中毒引起精神症状而无CO_2潴留者,可大胆地使用镇静剂。
This article reports on 43 cases of critically ill patients 89 cases of arterial blood gas measurement and rescue of critically ill patients with acid-base imbalance experience. It is considered that the treatment of acute and chronic respiratory acidosis should be mainly based on the positive improvement of aeration and the reduction of the original elevated PaCO_2. It is absolutely impossible to blindly make alkali. When the pH is less than 7.20, 40% sodium bicarbonate . The treatment of acute and chronic acidosis and alkali on the principle of treatment must be treated at the same time the two primary imbalance, that is, to actively improve ventilation and make up the amount of alkali, alkali should be slightly larger than those who simply sour. The principle of handling alkali poisoning is to start from the treatment of the primary imbalance, as soon as possible to restore the pH to normal, must not be mistaken for acid and blind make alkali, alkali poisoning caused mental symptoms without CO_2 retention, can be bold use of sedatives.