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目的探讨急性化学物中毒所致酸碱平衡紊乱对临床预后的影响。方法回顾性分析1990—2009年近20年间急性化学物中毒105例,分析酸碱平衡紊乱指标中pH值、PaO_2、PaCO_2、多重酸碱平衡紊乱与预后指标如死亡、器官损害及APACHE II评分的关系。结果各指标异常时出现死亡病例。不同pH值组、PaO_2组、酸碱组的器官损害程度、APACHEⅡ评分差异有统计学意义(P<0.05),异常组的器官损害严重程度、APACHEⅡ评分均升高。较重的二氧化碳潴留(PaCO_2>6.0 kPa)可导致多器官损害。结论急性化学物中毒致严重pH值异常、低氧血症、多重酸碱平衡紊乱均影响患者预后,导致不良后果,但在一定程度上能依此判断中毒预后,为临床早期救治提供证据。
Objective To investigate the impact of acute chemical poisoning caused by acid-base balance disorders on clinical prognosis. Methods A retrospective analysis of 105 cases of acute chemical poisoning in the past 20 years from 1990 to 2009 was conducted. The pH, PaO 2, PaCO 2, multiple acid-base balance disorders and prognostic indicators such as death, organ damage and APACHE II score relationship. The results of the death of any indicator of abnormalities. In different pH groups, the degree of organ damage, APACHEⅡscore in PaO_2 group, acid-base group were significantly different (P <0.05), and the severity of organ damage in abnormal group and APACHEⅡscore increased. Heavy carbon dioxide retention (PaCO_2> 6.0 kPa) can lead to multiple organ damage. Conclusions Acute chemical poisoning caused serious abnormal pH value. Hypoxemia and multiple acid-base balance disorders affect the prognosis of patients, leading to adverse consequences. However, to a certain extent, the prognosis of poisoning can be judged accordingly, providing evidence for early clinical treatment.