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目的探讨应用微量泵中心静脉补钾治疗重度低钾血症伴恶性室性心律失常有效性和安全性。方法对我院2011年6月—2012年6月收治的46例低钾血症(血钾浓度<2.5mmol/L)伴恶性室性心律失常的患者随机用微量泵经中心静脉恒速注射3%～6%氯化钾溶液,记录血钾上升所需时间、治疗补钾量、恶性心律失常消失时间。结果 46例患者2h内血钾缓慢上升,4h后上升较快,24h内血钾均恢复至(4.5±1.2)mmol/L,补钾总量(13.1±8.8)g,补钾量最多达32g,最少9g。38例有频发室速者4h内均明显减少,29例完全消失。7例室颤患者经反复除颤后恢复窦性心律,4h后未再出现室颤。结论在重度低钾血症伴恶性室性心律失常时,采用中心静脉微量泵入高浓度的氯化钾的方法是安全有效的。
Objective To investigate the effectiveness and safety of using micropump central venous potassium in the treatment of severe hypokalemia with malignant ventricular arrhythmias. Methods 46 cases of hypokalemia (serum potassium concentration <2.5mmol / L) with malignant ventricular arrhythmias admitted to our hospital from June 2011 to June 2012 were randomly divided into three groups: % ~ 6% potassium chloride solution, record the time required for the rise of serum potassium, the amount of potassium treatment, disappearance of malignant arrhythmia. Results The serum potassium level increased slowly within 2 hours in 46 patients and rapidly increased after 4 hours. The serum potassium level recovered to (4.5 ± 1.2) mmol / L in 24 hours, and the total amount of potassium supplement (13.1 ± 8.8) g and potassium up to 32g , At least 9g. 38 patients with frequent ventricular tachycardia within 4h were significantly reduced, 29 cases disappeared completely. Seven patients with ventricular fibrillation after repeated defibrillation to restore sinus rhythm, ventricular fibrillation did not occur after 4h. Conclusion In the severe hypokalemia with malignant ventricular arrhythmias, the use of central venous micro-pump high concentrations of potassium chloride is safe and effective.