探讨轻、重症肺炎患儿酸碱失衡的特点。

近5年在本院住院治疗的轻症肺炎患儿128例(轻症肺炎组)，重症肺炎患儿112例(重症肺炎组)。对其取手指动脉化毛细血管血进行血气分析。

重症肺炎组中，年龄为1～6个月的患儿占75.0%，轻症肺炎组中占49.2%，而其中小于3个月的患儿为多数。重症肺炎患儿的酸碱失衡类型以呼吸性酸中毒(呼酸)和混合性呼酸[呼酸＋代谢性酸中毒(代酸)和呼酸＋代谢性碱中毒(代碱)]多见(79.8%)，代酸和混合性代酸(呼酸＋代酸和呼碱＋代酸)也较常见。轻症肺炎患儿的酸碱失衡类型也为呼酸和混合性呼酸最多见(64.8%)，但代酸和混合性代酸少见，呼碱和混合性呼碱增加。由于肺炎患儿的PaCO₂经常存在原发性变化，故呼吸功能未明显改善之前，单纯性代酸和单纯性代碱少见。部分重症肺炎患儿无酸碱失衡。

患儿的年龄越小，感染时越容易累及下呼吸道而导致肺炎，且呈重症者较多。小婴儿患肺炎时，更容易产生呼吸道狭窄，导致肺通气减少，因此呼酸多见。病情越重，越容易发生代酸。重症肺炎患儿无酸碱失衡时，并不表示病情不严重。

To discuss the acid-base disorder of characteristics on the pneumonia children of slight or serious symptom.

The research objects are the pneumonia children who hospitalized in recent 5 years. In those patients, 128 cases are slight symptoms of pneumonia, and 112 cases are serious symptom of pneumonia. Sample the blood from arterial blood capillary which is from finger to analyze blood gas.

The age of some pneumonia children who are 1~6 months accounts for 75.0% in the team of serious symptom, 49.2% cases are in the team of slight symptom, and some children who are younger than 3 months old account for the most. The type of acid-base disorders in serious symptom is mainly respiratory acidosis and mixed respiratory acidosis (respiratory acidosis + metabolic acidosis and respiratory acidosis+ metabolic alkalosis), which accounts for 79.8% in all of the acid-base disorders. Moreover, the metabolic acidosis and the mixed metabolic acidosis (respiratory acidosis + metabolic acidosis and respiratory alkalosis+ metabolic acidosis) are also important. Furthermore, the type of acid-base disorders in slight symptom is mainly respiratory acidosis and mixed respiratory acidosis, which accounts for 64.8% in all of the acid-base disorders. However, the metabolic acidosis and the mixed metabolic acidosis occur seldom, and the proportion of the respiratory alkalosis and mixed respiratory alkalosis are increasing. Because the PaCO₂ of the pneumonia children change primarily, simple metabolic acidosis and metabolic alkalosis occur seldom before the respiratory function have not obviously ameliorate. In addition, some of the serious symptoms of children pneumonia sufferers have no acid-base disorders.

As the patients are younger, it will easily influence lower respiratory track when infects, and become pneumonia. Moreover, the serious symptom of children pneumonia sufferers account for higher percentages. It will easily engender respiratory track narrow when infants suffer pneumonia, and result in pulmonary ventilation decreasing. It is not indicated that the state of serious pneumonia have no acid-base disorders.