论文部分内容阅读
目的 探讨对于严重低钾血症 (K+ <2 5mmol/L)进行快速高浓度补钾目标性治疗策略的指征、疗效和安全性。方法 对于严重低钾血症 ,按 0 3～ 0 5mmol/(kg·h)的速度静脉输入补钾。将 15 %的氯化钾溶液用注射用水或 5 %葡萄糖液稀释成 0 3 %～ 1 5 %浓度 ,用输液泵均匀输入。当血钾 >3 0mmol/L改为常规补钾治疗。持续心电监护和经皮氧饱和度监护 ,补钾前查血钾、血气分析和心电图 ,快速补钾后每小时监测微量血钾。 结果 共 11例 ,14例次目标性补钾 ,补钾开始时血钾浓度1 8～ 3 0mmol/L ,平均 2 5 1mmol/L ,补钾持续时间 1～ 8 5小时 ,平均 6 64小时。钾绝对入量 4～ 5 0mmol/L ,平均 16 5mmol/L。静脉补钾液的浓度 0 3 %～ 5 1% ,平均 0 97%。输钾速度 0 3 0～ 0 5 8mmol/(kg·h) ,平均 0 44mmol/(kg·h)。微量生化血钾增长值 0 13～ 1 83mmol/L ,平均 0 68mmol/L ,每小时平均增长 0 10 3mmol/L。持续心电监护未发现任何与一过性血钾升高有关的心律紊乱。 结论 快速高浓度补钾目标性治疗策略 ,对于严重低钾血症治疗安全有效。
Objective To investigate the indications, curative effects and safety of targeted therapy of rapid and high potassium concentration in patients with severe hypokalemia (K + <25 mmol / L). Methods for severe hypokalemia, according to 0 3 ~ 0 5mmol / (kg · h) rate of intravenous infusion of potassium. 15% potassium chloride solution with water for injection or 5% glucose solution diluted to 0 3% ~ 15% concentration, with infusion pump input evenly. When serum potassium> 30mmol / L to conventional potassium treatment. Continuous ECG monitoring and monitoring of percutaneous oxygen saturation, potassium check blood potassium, blood gas analysis and electrocardiogram, potassium per hour after rapid potassium monitoring trace serum potassium. Results A total of 11 cases, 14 times the target of potassium, serum potassium concentration 18 ~ 30mmol / L, an average of 251mmol / L, potassium duration of 1 ~ 85 hours, an average of 644 hours. The absolute amount of potassium 4 ~ 5 0mmol / L, an average of 16 5mmol / L. Intravenous potassium concentration 0 3% ~ 5 1%, an average of 0 97%. The rate of potassium transport was 0 3 0 ~ 0 58 mmol / (kg · h) with an average of 0 44 mmol / (kg · h). Microbial serum potassium increased 0 13 ~ 1 83mmol / L, an average of 0 68mmol / L, an average increase of 0 10 3mmol / L per hour. Persistent ECG did not find any arrhythmia associated with transient hyperkalemia. Conclusion The target of rapid and high concentration potassium therapy is safe and effective for the treatment of severe hypokalemia.