低濃度氨水在癔癥致呼吸性堿中毒患者中的應(yīng)用效果評(píng)價(jià)

汪杏　李素文

[摘要] 目的 探討低濃度氨水在癔癥致呼吸性堿中毒患者中的應(yīng)用效果。方法 方便選取2015年10月—2018年5月經(jīng)江蘇衛(wèi)生健康職業(yè)學(xué)院附屬南京市高淳人民醫(yī)院院急診科確診的100例癔癥致呼吸性堿中毒的患者隨機(jī)分為對(duì)照組和實(shí)驗(yàn)組，對(duì)照組根據(jù)醫(yī)生的醫(yī)囑常規(guī)應(yīng)用鎮(zhèn)靜藥物抑制患者的過度呼吸，實(shí)驗(yàn)組通過吸入低濃度氨水（5 ppm）來抑制患者的過度呼吸，對(duì)兩種方法的治療效果及兩組患者癥狀緩解時(shí)間進(jìn)行對(duì)比，并比較吸入氨水組患者吸入氨水前后的血?dú)夥治鲋?，評(píng)價(jià)低濃度氨水對(duì)癔癥導(dǎo)致的呼吸性堿中毒患者的治療效果。 結(jié)果 對(duì)照組癥狀緩解，平均時(shí)間為（206.18±99.22）min，實(shí)驗(yàn)組最長(zhǎng)60 min，最短5 min，平均時(shí)間為（32.12±17.46）min，有效率為100%，明顯高于對(duì)照組84%（χ2=7.53，t=12.22），差異有統(tǒng)計(jì)學(xué)意義（P<0.05），而且吸入氨水后血?dú)夥治鲋礟aCO2（29.08±8.91）BEecf（-1.19±2.16）mmol/L、AB（21.67±3.26）mmol/L、總二氧化碳（22.63±3.43）mmol/L變化對(duì)比吸入前（19.55±6.32）mmHg、（-3.91±2.29）mmol/L、（17.82±2.80）mmol/L、（18.44±2.96）mmol/L，差異有統(tǒng)計(jì)學(xué)意義（t=6.20、6.11、6.33、6.54）。 結(jié)論 低濃度氨水可有效控制癔癥致呼吸性堿中毒患者的過度換氣癥狀，有效率為100%，緩解癥狀的時(shí)間最長(zhǎng)60 min，最短5 min，較藥物及其他方法治療效果更快。

[關(guān)鍵詞] 低濃度氨水;呼吸性堿中毒;應(yīng)用效果

[中圖分類號(hào)] R473? ? ? ? ? [文獻(xiàn)標(biāo)識(shí)碼] A? ? ? ? ? [文章編號(hào)] 1674-0742（2019）05（b）-0091-03

[Abstract] Objective To investigate the effect of low concentration aqueous ammonia in patients with respiratory alkalosis caused by sputum. Methods From October 2015 to May 2018， 100 patients with respiratory alkalosis diagnosed by sputum in the emergency department of Nanjing Gaochun People's Hospital affiliated to Jiangsu Health and Health Vocational College were convenient selected and randomly divided into control group and experimental group. The conventional application of sedative drugs inhibited the patient's excessive respiration. The experimental group inhibited the patient's excessive respiration by inhaling low-concentration ammonia （5 ppm）. The therapeutic effects of the two methods and the symptom relief time of the two groups were compared， and the inhaled ammonia group was compared. Blood gas analysis values before and after inhalation of ammonia water were used to evaluate the therapeutic effect of low-concentration ammonia water on patients with respiratory alkalosis caused by sputum. Results The symptom remission time of the control group，the average time was （206.18±99.22）min， the experimental group，the average time was （32.12±17.46）min， and the effective rate was 100%， higher than the control group of 84%. The data showed statistical significance between the groups （P<0.05）， and the blood gas analysis value PaCO2（29.08±8.91） BEecf （-1.19±2.16）mmol/L after inhalation of ammonia water， AB （21.67±3.26）mmol/L， total carbon dioxide （22.63±3.43）mmol/L change before the inhalation （19.55±6.32）mmHg， （-3.91±2.29）mmHg， （17.82±2.80）mmHg， 18.44±2.96）mmHg，respectively， with statistical significance（t=6.20， 6.11， 6.33， 6.54，P<0.05）. Conclusion Low-concentration ammonia can effectively control the hyperventilation symptoms of patients with respiratory alkalosis caused by sputum， the effective rate was 100%， the time to relieve symptoms was up to 60 minutes， and the shortest time was 5 minutes， faster than that of drugs and other methods.

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（收稿日期：2019-02-18）