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为了正确判断重型病毒性肝炎患者酸碱失衡(ABD),联合运用ABD预计代偿公式、阴离子隙(AG)和潜在HCO_3~-,分析了244例次血气分析和电解质测定参数。仅用预计代偿公式判断,131例次为单纯ABD(53.7%),113例次为二重ABD(46.3%);加用AG分析使47例次单纯ABD改判为二重ABD,19例次二重ABD判为三重ABD;再加用潜在HCO_3~-分析,三重ABD由19例次(7.8%)增至97例次(32.4%)。重肝ABD以呼碱、呼碱并代碱及呼碱代酸并代碱为常见。碱血症与酸血症之比为2.26:1。三ABD患者并发症率及病死率均明显高于单纯ABD。提示潜在HCO_3~-及AG对正确判断混合ABD尤其是三重ABD有重要价值,ABD对预后判断有一定价值。
In order to correctly determine the acid-base imbalance (ABD) in patients with severe viral hepatitis, 244 blood gas analysis and electrolyte determination parameters were analyzed using ABD predicted compensation formula, anion gap (AG) and potential HCO 3 ~ -. Judging by the predicted compensation formula, only 131 cases were simple ABD (53.7%) and 113 cases were double ABD (46.3%). Plus AG analysis, 47 cases of simple ABD were changed to double ABD, 19 cases Double ABD was classified as triple ABD. Combined with the potential HCO 3 analysis, the triple ABD increased from 19 (7.8%) to 97 (32.4%). Heavy liver ABD to call alkali, call alkali and alkali generation and call alkali acid and alkali generation is common. Alkalipinemia and acidosis ratio of 2.26: 1. Three ABD patients with complication rate and mortality were significantly higher than simple ABD. Prompt potential HCO 3 ~ - and AG to correctly determine mixed ABD especially triple ABD has important value, ABD has a certain value in the prognosis.