血气研究在诊断尿毒症患者中临床价值.docVIP

血气研究在诊断尿毒症患者中临床价值[摘要] 目的：探讨分析血气分析在早期诊断尿毒症患者中的临床价值。方法：对172例患者进行回顾性分析，其中正常对照组60例，氮质血症组60例，尿毒症组52例。结合临床实际对比分析各组血气分析指标异常情况。结果：氮质血症组出现代谢酸中毒，其pH、PaCO2、HCO3-均比正常组有所降低（P＜0.05），PaO2、SaO2虽较正常组有所降低，但都在正常范围内，且其PaCO2属于代偿性降低。尿毒症组则显示出明显的失代偿性代谢性酸中毒，PaO2轻度降低，部分患者出现CO2潴留。其血气分析指标紊乱程度均高于氮质血症组（P＜0.05）。结论：血气分析异常指标及其强弱程度与肾脏的受损程度密切相关，血气分析有助于早期发现及诊断尿毒症患者，应在目前的医疗基础上加强尿毒症患者的常规血气分析检查。 [关键词] 血气分析；尿毒症；诊断；临床价值 [中图分类号] R69 [文献标识码]A[文章编号]1674-4721（2011）07（b）-025-02 The clinical value of blood gas analysis in diagnosis of uremic patients HE Jianming Guangzhou First Municipal People′s Hospital, Guangdong Province, Guangzhou 510180, China [Abstract] Objective: To analyze the clinical value of blood gas analysis in early diagnosis of uremic patients. Methods: Retrospectively analyzed the clinical data of 172 patients. 60 cases of normal control group, 60 patients of Nitrogen qualitative hematic disease group, 52 cases uremic patients group. Comparativly analyzed of blood gas analysis in the difference between the groups combined with clinical. Results: Azotemia group showed metabolic acidosis, the pH, PaCO2, HCO3- decreased than normal group (P＜0.05), the PaO2, SaO2, although somewhat lower than the normal group, but all within the normal range, and the PaCO2 was reduced compensatory. Uremic group showed significantly decompensated acidosis, PaO2 decreased slightly, some patients had CO2 retention. The degree of blood gas analysis disorder were higher than azotemia (P＜0.05). Conclusion: Abnormal blood gas analysis indicators and their intensity level is closely related with kidney damage, blood gas analysis would be help for earlier detection and diagnosis of patients with uremia, uremic patients should be strengthened inspection routine blood gas analysis. [Key words] Blood gas analysis; Uremia; Diagnosis; Clinical value 尿毒症是慢性肾衰竭（CRF）发展的第四个阶段（分别为肾功能代偿期、肾功能失代偿期、肾功能衰竭期即尿毒症前期、以及尿毒症期），近20年来慢性肾衰竭在人类主要死亡病因中占第5~9位，是人类生存的重要威胁之一。慢性肾衰竭主要病因有糖尿病肾病、高血压肾小动脉硬化，原发性与继发性肾小球肾炎等。尿毒症期伴随全身各脏器损害及合并各