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目的通过对呼吸系统重症患者动脉血气的指标及其变化情况进行分析,为临床准确的指导性治疗提供依据。方法选用GEMPremier3000型血气分析仪对本院呼吸科148例危重患者进行动脉血气的全自动检测。并与对照组30例相比较,从pH,PCO2,PO2和HCO-3等主要血气指标的变化分析,得出血气诊断及统计结果。结果与对照组相比较,支气管哮喘组、慢性阻塞性肺气肿组、呼吸衰竭组和晚期肺癌组pH显著降低,差异有统计学意义(P<0.01)。慢性阻塞性肺气肿组、呼吸衰竭组和晚期肺癌组PaO2明显降低,差异有统计学意义,(P<0.01),慢性阻塞性肺气肿组、呼吸衰竭组PaCO2升高显著,差异有统计学意义(P<0.01),慢性阻塞性肺气肿组、呼吸衰竭组HCO3-显著升高,差异有统计学意义(P<0.01)。支气管哮喘组PaO2降低显著,差异有统计学意义(P<0.05),并主要表现为呼吸性碱中毒或呼吸性酸中毒,慢性阻塞性肺气肿组、呼吸衰竭组和晚期肺癌组主要以呼酸或呼酸合并代碱为主,除晚期肺癌外还出现多种酸碱失衡的临床改变。结论动脉血气监测可用于评价呼吸功能状况和判断酸碱失衡类型,对危重患者的及时救治和预后判断具有重要的临床参考价值。
Objective To analyze the indexes and changes of arterial blood gases in critically ill patients with respiratory system and provide the basis for clinical accurate guidance and treatment. Methods The GEMPremier3000 blood gas analyzer was used to detect arterial blood gas in 148 critically ill patients in the Department of Respiratory Medicine. And compared with the control group of 30 cases, from the pH, PCO2, PO2 and HCO-3 and other major indicators of blood gas changes, come to blood gas diagnosis and statistical results. Results Compared with the control group, the pH of bronchial asthma group, chronic obstructive pulmonary emphysema group, respiratory failure group and advanced lung cancer group was significantly lower (P <0.01). PaO2 in chronic obstructive emphysema group, respiratory failure group and advanced lung cancer group was significantly lower than that in the control group (P <0.01), PaCO2 in chronic obstructive emphysema group and respiratory failure group increased significantly Significance (P <0.01), chronic obstructive pulmonary emphysema group, respiratory failure group HCO3-significantly increased, the difference was statistically significant (P <0.01). Bronchial asthma group PaO2 decreased significantly, the difference was statistically significant (P <0.05), and mainly for respiratory alkalosis or respiratory acidosis, chronic obstructive pulmonary disease group, respiratory failure group and advanced lung cancer group mainly call Acid or sour acid combined alkali generation, in addition to advanced lung cancer also appeared a variety of acid-base imbalance clinical changes. Conclusion Arterial blood gas monitoring can be used to evaluate the status of respiratory function and determine the type of acid-base imbalance, which has important clinical reference value for prompt treatment and prognosis of critically ill patients.