新生儿三重酸碱失衡影响因素及临床分析

发布时间：2018-07-14 21:42

【摘要】：目的:了解新生儿三重酸碱失衡(TABD)的影响因素。方法:随机纳入171例患儿,检测动脉血气和血电解质,计算阴离子间隙、潜在HCO-3及HCO-3间隙;依据TABD诊断标准分为单纯酸碱失衡(ABD)组、双重ABD组及TABD组进行研究。结果:171例患儿中TABD组病死率16.67%,高于单纯ABD、双重ABD组(P0.05)。低碳酸血症型发生率占总TABD的81.48%。窒息或颅内损伤、呼吸窘迫综合征、出血症、感染等基础疾病,缺氧、热卡不足、凝血异常、少尿等合并症,以及治疗差异(机械通气、血液制品、排钾利尿剂、禁食及胃肠减压)均严重影响TABD发生,其作用远高于对单纯及双重ABD组的影响(P0.01或P0.05)。结论:在院新生儿TABD高发生率与基础疾病、合并症及治疗有关,且影响预后;低碳酸血症型TABD是新生儿TABD的主要表现形式。
[Abstract]:Objective: to investigate the influencing factors of neonatal triple acid-base imbalance (TABD). Methods: 171 children were randomly divided into three groups: simple acid-base imbalance (Abd) group, double ABD group and TABD group according to TABD diagnostic criteria, arterial blood gas and electrolyte were measured, anion gap, potential HCO-3 and HCO-3 interspace were calculated. Results among 171 cases, the mortality of TABD group was 16.67, higher than that of simple ABD group and double ABD group (P0.05). The incidence of hypocapnia was 81.48% of total TABD. Asphyxia or intracranial injury, respiratory distress syndrome, hemorrhage, infection and other underlying diseases, hypoxia, insufficient heat calorie, coagulation abnormalities, oliguria and other complications, and treatment differences (mechanical ventilation, blood products, potassium diuretics, etc.) Fasting and gastrointestinal decompression significantly affected the occurrence of TABD, which was much higher than that in simple and double ABD groups (P0.01 or P0.05). Conclusion: the high incidence of neonatal TABD in hospital is related to the underlying diseases, complications and treatment, and affects the prognosis, and low carbon acidemia type TABD is the main manifestation of neonatal TABD.
【作者单位】：南京医科大学第二临床医学院;
【分类号】：R722.1

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