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目的探讨非挤压创伤患者大量输血后高钾血症发生率及其危险因素。方法选择香河县人民医院2010年1月至2014年1月期间收治的102例非挤压创伤大量输血患者为研究组,对照组为94例同期外伤无输血患者。对两组患者术前、术后、术后12 h血钾进行水平测定。同时对高钾血症发生的相关影响因素进行分析。结果两组患者在年龄、性别及创伤方式等方面差异无统计学意义(P>0.05),而在创伤严重程度方面差异有统计学意义(P<0.05)。两组患者术前、术后及术后12 h血钾比较差异无统计学意义(P>0.05)。研究组术后高钾血症的发生率高于对照组(P<0.05),而两组术后12 h高钾血症发生率差异无统计学意义(P>0.05)。大量输血与术后高钾血症无明显相关性(OR=0.64,95%CI:0.041~5.297,P>0.05),而术前高血钾和术后p H值降低是高钾血症的主要危险因素。结论大量输血治疗并未直接导致高血钾的发生,但仍有一定的高钾血症发生率,因此在输血治疗过程中仍需动态监测血钾的变化,以降低高血钾所带来的并发症。
Objective To investigate the incidence and risk factors of hyperkalemia after massive blood transfusion in patients with non-crush trauma. Methods A total of 102 cases of non-squeezing trauma patients admitted to Xianghe People’s Hospital from January 2010 to January 2014 were selected as the study group and 94 cases of the same traumatic injury without blood transfusion. Preoperative, postoperative, postoperative 12 h serum potassium levels were measured. At the same time, the related influencing factors of hyperkalemia were analyzed. Results There was no significant difference in age, sex and trauma between the two groups (P> 0.05), but there was significant difference in the severity of trauma (P <0.05). There was no significant difference in serum potassium level between the two groups before, after and 12 h (P> 0.05). The incidence of postoperative hyperkalemia was higher in the study group than in the control group (P <0.05), but there was no significant difference in the incidence of hyperkalemia between the two groups (P> 0.05). There was no significant correlation between blood transfusion and postoperative hyperkalemia (OR = 0.64, 95% CI: 0.041-5.297, P> 0.05), while preoperative hyperkalemia and postoperative p H decrease were hyperkalemia The main risk factors. Conclusion A large number of blood transfusion does not directly lead to the occurrence of hyperkalemia, but there is still a certain incidence of hyperkalemia, so blood transfusion in the process of monitoring the need for dynamic changes in serum potassium to reduce hyperkalemia complication.