Department of Medicine, Division of Nephrology & Hypertension, UMDNJ-New Jersey Medical School, Newark, NJ 07103, USA.
Am J Emerg Med. 2012 Jan;30(1):260.e5-8. doi: 10.1016/j.ajem.2010.10.035. Epub 2010 Dec 24.
We report a case of triple acid-base disorder with metabolic alkalosis as the primary disorder in a 65-year-old man due to ingestion and application to leg ulcers of baking soda (calcium bicarbonate). The blood pH was 7.65 with hypochloremia, hypokalemia, and prerenal azotemia. He was treated with isotonic saline with K replacement, and the patient improved without any adverse clinical consequences. We discuss the causes, mechanisms, and management of Cl-responsive (depletion) metabolic alkalosis.
我们报告了一例三重酸碱紊乱病例，其中代谢性碱中毒是主要异常，发生于一位 65 岁男性，病因是摄入并涂抹小苏打（碳酸氢钙）至腿部溃疡。患者的血液 pH 值为 7.65，伴有低氯血症、低钾血症和肾前氮质血症。他接受了等渗盐水和钾补充治疗，患者情况改善，无任何不良临床后果。我们讨论了氯反应性（耗竭）代谢性碱中毒的病因、机制和处理方法。
