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本文对85例(92例次)肺心呼衰患者的血气及并发症进行分析,并就血气的改变与并发症的出观对预后的影响进行探讨。分析资料提示入院危重时的Paco_2是影响预后的主要因素。Paco_2≤80托的病死率为40％而Paco_2<80托者为25.86％,X~2检验差别显著(P<0.05)。pH≤7.30与PaO_2≤50(或55)托的病死率虽高于pH>7.30与PaO_2>50(或55)托者,但差别不显著(P>0.05)。 各种并发症的出现都能对预后产生不同程度的影响,其中较严重者为肺脑、感染性休克、上消化道出血、酸硷失衡、电解质紊乱、肾功能、DIC及肺水肿等。文中强调对肺心呼衰患者除应注意呼酸与低钾外,还应注意代谢性酸中毒以及硷中毒(代硷或呼硷)的极积防治。对并发肺脑、休克与上消化道出血者,尤其是对严重难以纠正者,应警惕DIC的合并。氮质血症与高GPT血症对预后的估计有一定的意义。膀胱潴留和腹鼓胀并发者亦不太少见,对发病原理及治疗的初步意见,文内简予讨论。
In this paper, the blood gas and complications of 85 cases (92 cases) of CPH were analyzed, and the influence of blood gas changes and complications on the prognosis was discussed. Analysis of data suggest Paco_2 at admission is a major factor affecting the prognosis. The case fatality rate was 40% for Paco_2 ≤ 80 Torr and 25.86% for Paco_2 <80, with a significant difference between the X ~ 2 test (P <0.05). The mortality of patients with pH≤7.30 and PaO_2≤50 (or 55) was higher than those with pH> 7.30 and PaO_2> 50 (or 55), but the difference was not significant (P> 0.05). A variety of complications can have varying degrees of prognosis, of which more serious were pulmonary, septic shock, upper gastrointestinal bleeding, acid-base imbalance, electrolyte imbalance, renal function, DIC and pulmonary edema. The paper emphasizes that in patients with pulmonary heart failure patients should pay attention in addition to sour and low potassium, but also pay attention to metabolic acidosis and alkalosis (alkaloids or alkaloids) of the plot prevention and treatment. Of pulmonary heart disease, shock and upper gastrointestinal bleeding, especially for those who are seriously difficult to correct, should be alert to the merger of DIC. Azotemia and high GPT hyperlipidemia prognosis of a certain significance. Bladder retention and abdominal bloating complicated by those who are not uncommon, the pathogenesis and treatment of the initial observations, the text briefly discussed.