88例SARS患者的血气分析及临床研究

首都医科大学学报 ›› 2003, Vol. 24 ›› Issue (4): 430-433.

88例SARS患者的血气分析及临床研究

吴昊¹, 陈新月¹, 黄云丽¹, 张永宏¹, 马丽娜¹, 王作梅¹, 张彤¹, 李在村¹, 王辰²

1. 北京佑安医院;2. 首都医科大学附属北京朝阳医院

收稿日期:2003-07-17 修回日期:1900-01-01 出版日期:2003-10-15 发布日期:2003-10-15

Clinical Analysis of Blood Gas in 88 Patients with Severe Acute Respiratory Syndrome

Wu Hao¹, Chen Xinyue¹, Huang Yunli¹, Zhang Yonghong¹, Ma Lina¹, Wang Zuomei¹, Zhang Tong¹, Li Zaicun¹, Wang Chen²

Beijing Youan Hospital

Received:2003-07-17 Revised:1900-01-01 Online:2003-10-15 Published:2003-10-15

摘要/Abstract

摘要： 为探讨SARS患者血氧代谢的特点及其与临床的相关性,采用回顾性分析研究的方法。结果1)我院88例SARS患者共检测血气213例次,血气异常率以动脉血氧分压(PaO₂)降低最多见,为85.0%(181/213例次),动脉血氧饱和度(SaO₂)降低占68.1%(145/213例次),动脉二氧化碳分压(PaCO₂)增高仅占5.6%(12/213次)。表明SARS患者低氧血症发生率最高,二氧化碳储留不多见。2)低氧血症与临床病型和病期相关,重型、极重型较普通型SARS的缺氧表现明显,病程进展期和极期PaO₂较低下。3)多数SARS患者存在呼吸性碱中毒(简称呼碱)。死亡病例除呼碱外,常有复合性酸碱紊乱。结果提示1)SARS患者病程初期即有PaO₂降低,低氧血症刺激过度通气,PaCO₂降低引起呼碱,进一步发展为复合性酸碱失衡,或表现为CO₂储留,导致呼吸性酸中毒(简称呼酸)。2)低氧血症与临床病情及预后相关,治疗中应重视早期给氧治疗。

关键词: 严重急性呼吸综合征, 血气分析, 低氧血症

Abstract: The objective was to discuss the characteristics of metabolism of oxygen and its correlation with clinical manifestations in Severe Acute Respiratory Syndrome.Retrospective study was designed.Blood gas in 88 patients was detected up to 213 times.It was found that the decrease of PaO₂ was the most common(85.0%,181/213),the decrease of SaO₂ is the second(68.1%,145/213),and the increase of PaCO₂ is the least common(5.6%,12/213).All the data indicated that the incidence of hypoxemia was the most prevalent and the increase of carbon dioxide was the least in all these patients.Hy-poxemia,clinical typing and phase were correlated,and respiratory alkalosis was widespread.In patients who died of SARS,there were not only respiratory alkalosis but also compound disorder of blood gas.The variation of metabolism of oxygen is the decrease of PaO₂ in the initial stage and overventilation excited by hypoxemia.At the same time the decrease of PaCO₂ causes respiratory alkalosis,and the development of compound disorder of blood gas.Correlation exists between hypoxemia,clinical condition and prognosis,indicating that the treatment of oxygen in the initial stage is important.

Key words: atypical pneumonia, SARS, blood gas analysis, hypoxemia *Beijing Chaoyang Hospital, Affiliate of Capital University of Medical Sciences

中图分类号:

R563.1

吴昊;陈新月;黄云丽;张永宏;马丽娜;王作梅;张彤;李在村;王辰. 88例SARS患者的血气分析及临床研究[J]. 首都医科大学学报, 2003, 24(4): 430-433.

Wu Hao;Chen Xinyue;Huang Yunli;Zhang Yonghong;Ma Lina;Wang Zuomei;Zhang Tong;Li Zaicun;Wang Chen. Clinical Analysis of Blood Gas in 88 Patients with Severe Acute Respiratory Syndrome[J]. Journal of Capital Medical University, 2003, 24(4): 430-433.

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