重度低钾血症100例病因及心电图分析

目的:探讨重度低钾血症的病因,研究其心电图( ECG)表现对低钾血症的诊断价值.方法:100例重度低钾血症患者均在入院后48 h以内测定血清钾以确诊,其中＜60岁者21例,≥60岁者79例.100例均行常规12导联ECG检查,同时给予补钾、补镁等对症治疗.结果:①100例中,90例经3～7d治疗后,复查血清钾正常;6例自动出院;3例因恶性肿瘤终末期放弃治疗死亡;1例因心室颤动抢救无效死亡;治愈率90%.②＜60岁患者中,周期性低钾性麻痹患者16例,原发病引起低钾者5例;≥60岁患者中,因原发病造成钾摄入不足引发者76例,因使用排钾药物引起者3例.③所有患者均有低钾血症ECG异常改变.结论:低钾血症的病因可能与周期性低钾性麻痹及原发病钾摄入不足有关;ECG检查方便迅速,对重度低钾血症者的救治有相当的价值.

Etiology and Electrocardiogram Analysis in 100 Patients with Severe Hypokalemia

Objective：To explore the etiology of severe hypokalemia and the role of electrocardiogram in the diagnosis of severe hypokalemia, nethods：100 patients with severe hypokalemia were finally diagnosed within 48 hours of hospitalization. Among those, 21 cases with age 〈60 years, 79 cases with age ≥60 years. All patients were monitored by electrocardiography and were treated by administration of kalium, magnesium supplement and symptomatic treatment. Results：（1） Among 100 patients with severe hypokalemia, after 3 -7 days treatment, 90 cases recovered from severe hypokalemia, 6 cases voluntarily discharged, 3 cases quitted treating and died due to terminal cancer, 1 case was dead because of ventricular fibrillation, the cure rate was 90%. （2） In patients with age 〈60 years, 16 cases were hypokalemic periodic paralysis, 3 cases were caused by insufficient intake owing to protopathy. In patients with age 960 years, 76 cases with insufficient of intake owing to protopathy which was the leading cause to severe hypokalemia, 3 cases resulted from the use of the potassium drugs. （3） All patients had electrocardiogram change of hypokaiemia. Conclusions：The main cause of severe hypokalemia is likely related to hypokalemic periodic paralysis and insufficient intake owing to protopa- thy, Electrocardiogram is convenient and rapid, there is considerable value in the treatment of severe hypokalemia.