摘要
对30例目击下心跳骤停患者复苏后早期动脉血气变化进行分析,探讨复苏期间体内酸碱状态的变化规律、影响因素及预后意义。结果显示,复苏期间酸碱失衡的发生与 CPR 持续时间、碱性溶液应用及通气状况等多种因素有关;出现重症酸中毒提示预后不良。充分的通气供氧是复苏期间防治酸中毒的基本措施,过度通气可部分代偿代酸,CPR 时间在10～15分钟以内者无须补碱,超过这一时间则有必要在动脉血气分析结果指导下适量补碱。但动脉血正常血气的预后意义尚须探讨。
In order to evaluate the acid—basic status and the influencing factors during the cardiopul- monary resuscitation,a series of arterial blood gas were drawed immediately after successful cardiopuomonary resuscitations in 30 patients having had sudden cardiac arrests in our emer- gency department.The patient with underlying disorders which would influenee the acid—ba- sic status were climited from the study.The results showed that:the severity of acidosis dur- ing the resuscitation was related to the persistance of CPR,the administration of bicarbon- ate,and the quality of artificial ventilation.In well ventilated patients,no significant metabolic acidosis occurred during the first 12 to 15 minutes.After this period,severe metablic acidosis occurred in all of 4 patients who did not receive bicarbonate but only 5 of 14 who received it.There were statistically sighificant difference between the two groups.The severe arterial blood acidosis in the early stage of post—resuscitation period suggested a poor prognosis.All who had severe acidosis died whereas only 3 of 14 with mild acidosis died in two weeks(P<0.05).We conclude that in witnessed cardiac arrest,the metabolic acidosis is not the main problem in the early stage and the bicarbonate need not be considered.Appro- priate hyperventilation and oxygen supply are the primary methods to prevent acidosis.If the automatic circulation can not be restored after 12 to 15 minutes,the severe metabolic acidosis will occur unavoidly and the sodium bicarbanate should be given in seperate doses according to the arterial blood gas.
出处
《急诊医学》
CSCD
1993年第3期179-179,共1页
