低浓度氨水在癔症致呼吸性碱中毒患者中的应用效果评价

汪杏　李素文

[摘要] 目的 探讨低浓度氨水在癔症致呼吸性碱中毒患者中的应用效果。方法 方便选取2015年10月—2018年5月经江苏卫生健康职业学院附属南京市高淳人民医院院急诊科确诊的100例癔症致呼吸性碱中毒的患者随机分为对照组和实验组，对照组根据医生的医嘱常规应用镇静藥物抑制患者的过度呼吸，实验组通过吸入低浓度氨水（5 ppm）来抑制患者的过度呼吸，对两种方法的治疗效果及两组患者症状缓解时间进行对比，并比较吸入氨水组患者吸入氨水前后的血气分析值，评价低浓度氨水对癔症导致的呼吸性碱中毒患者的治疗效果。 结果 对照组症状缓解，平均时间为（206.18±99.22）min，实验组最长60 min，最短5 min，平均时间为（32.12±17.46）min，有效率为100%，明显高于对照组84%（χ2=7.53，t=12.22），差异有统计学意义（P<0.05），而且吸入氨水后血气分析值PaCO2（29.08±8.91）BEecf（-1.19±2.16）mmol/L、AB（21.67±3.26）mmol/L、总二氧化碳（22.63±3.43）mmol/L变化对比吸入前（19.55±6.32）mmHg、（-3.91±2.29）mmol/L、（17.82±2.80）mmol/L、（18.44±2.96）mmol/L，差异有统计学意义（t=6.20、6.11、6.33、6.54）。 结论 低浓度氨水可有效控制癔症致呼吸性碱中毒患者的过度换气症状，有效率为100%，缓解症状的时间最长60 min，最短5 min，较药物及其他方法治疗效果更快。

[关键词] 低浓度氨水;呼吸性碱中毒;应用效果

[中图分类号] R473          [文献标识码] A          [文章编号] 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）