低濃度氨水在癔癥致呼吸性堿中毒患者中的應用效果評價

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用效果。方法 方便選取2015年10月—2018年5月經江蘇衛生健康職業學院附屬南京市高淳人民醫院院急診科確診的100例癔癥致呼吸性堿中毒的患者隨機分為對照組和實驗組，對照組根據醫生的醫囑常規應用鎮靜藥物抑制患者的過度呼吸，實驗組通過吸入低濃度氨水（5 ppm）來抑制患者的過度呼吸，對兩種方法的治療效果及兩組患者癥狀緩解時間進行對比，并比較吸入氨水組患者吸入氨水前后的血氣分析值，評價低濃度氨水對癔癥導致的呼吸性堿中毒患者的治療效果。 結果 對照組癥狀緩解，平均時間為（206.18±99.22）min，實驗組最長60 min，最短5 min，平均時間為（32.12±17.46）min，有效率為100%，明顯高于對照組84%（χ2=7.53，t=12.22），差異有統計學意義（P<0.05），而且吸入氨水后血氣分析值PaCO2（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，差異有統計學意義（t=6.20、6.11、6.33、6.54）。 結論 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%，緩解癥狀的時間最長60 min，最短5 min，較藥物及其他方法治療效果更快。

[關鍵詞] 低濃度氨水;呼吸性堿中毒;應用效果

[中圖分類號] R473? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 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.

[3]? Batlle D，Chin-Theodorou J，Tucker BM. Metabolic Acidosis or Respiratory Alkalosis Evaluation of a Low Plasma Bicarbonate Using the Urine Anion Gap[J]. American Journal of Kidney Diseases， 2017：S0272638617306996.

[4]? Tsuji B，? Hayashi K，? Kondo N， et al. Characteristics of hyperthermia-induced hyperventilation in humans[J]. Temperature， 2016， 3（1）：146-160.

[5]? 顏丹紅，李素琴.癔癥患者述情障礙現狀及影響因素分析[J].護理管理雜志，2015，15（6）：389-391.

[6]? 李俊彥. 針刺四關穴結合按摩暗示療法治愈癔癥性眼病一例[J]. 上海醫藥， 2017， 38（6）：37-38.

[7]? 王青. 《金鳳釵記》與“癔癥性附體”——古典小說與精神疾患之三[J]. 古典文學知識， 2017（6）：46-48.

[8]? Johnson RA. A Quick Reference on Respiratory Alkalosis[J]. Veterinary Clinics of North America Small Animal Practice， 2016， 47（2）：181-184.

[9]? Liu F，? Celi P，? Chauhan SS， et al. A short-term supranutritional vitamin E supplementation alleviated respiratory alkalosis but did not reduce oxidative stress in heat stressed pigs[J]. Asian-Australasian Journal of Animal Sciences， 2018， 31（2）：263-269.

（收稿日期：2019-02-18）