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目的观察直肠癌病人人院至手术前血钾浓度的变化,为预防直肠癌病人术前低钾血症提供临床依据。方法收集2015年1月至2015年12月期间进行直肠癌手术治疗并符合本研究条件的病人资料。其中男性20例,女性16例;年龄在27~77岁,平均年龄51.0岁;病程在1~30个月,平均病程7个月;术前住院天数为4~8 d,平均为5 d。分三个时间点监测36例直肠癌病人自入院至手术之前的血钾浓度变化,即入院第1天、服用泻药前、手术当天早晨,并根据术前是否补钾进行分组,即观察组(补钾)、对照组(未补钾),观察各时间点之间及两组之间血钾浓度,使用SPSS(18.0版)统计软件进行统计分析。结果对照组病人血钾浓度平均值入院第1天为(4.17±0.68)mmol/L;服用泻药前为(3.80±0.50)mmol/L,较入院第1天有所下降,差异有统计学意义(P<0.01);手术当天早晨为(3.38±0.43)mmol/L,与前两次差异均有统计学意义(P<0.01)。观察组各时间点血钾浓度差异无统计学意义(P>0.05);观察组与对照组在入院时血钾浓度差异无统计学意义(P>0.05),在服用泻药前及手术当天早晨差异均有统计学意义(P<0.05和P<0.01)。结论直肠癌病人手术之前即可能处于低钾血症状态,其原因可能与入院后饮食结构改变及服用泻药清洁肠道相关,人院后至术前进行常规补钾可预防直肠癌病人术前低钾血症的发生。
Objective To observe the changes of serum potassium concentration in patients with rectal cancer before surgery to provide a clinical basis for the prevention of preoperative hypokalemia in patients with rectal cancer. Methods The data of patients who underwent surgery for rectal cancer during January 2015 to December 2015 and who met the criteria of this study were collected. Including 20 males and 16 females. The average age was from 27 to 77 years. The average age was 51.0 years. The course of disease ranged from 1 to 30 months with an average duration of 7 months. The days of preoperative hospitalization ranged from 4 to 8 days with an average of 5 days. 36 cases of rectal cancer patients were monitored at three time points from admission to surgery before the change in serum potassium concentration, that is, the first day of admission, taking laxatives, the morning of the day of surgery, and according to whether preoperative potassium, the observation group ( Potassium). The control group (without potassium) was used to observe the serum potassium concentrations at different time points and between the two groups. Statistical analysis was performed using statistical software SPSS (version 18.0). Results The mean serum potassium concentration in the control group was (4.17 ± 0.68) mmol / L on day 1 and (3.80 ± 0.50) mmol / L before laxative administration, which was lower than that on the first day after admission (P <0.01). The morning (3.38 ± 0.43) mmol / L on the day of surgery was significantly different from the former two (P <0.01). There was no significant difference in serum potassium concentration in observation group at each time point (P> 0.05). There was no significant difference in serum potassium concentration between observation group and control group at admission (P> 0.05) All were statistically significant (P <0.05 and P <0.01). Conclusions Rectal cancer patients may be in hypokalemia state before surgery. The reason may be related to dietary changes after admission and laxative cleaning of intestinal tract. Conventional potassium supplement can prevent preoperative low-grade preoperative The occurrence of kappa.