婴幼儿严重低钾血症11例疗效分析

目的分析婴幼儿严重低钾血症的诊治及其顸后，为婴幼儿严重低钾血症的临床治疗提供参考。方法回顾性分析2010年1月至2013年3月收治的11例婴幼儿严重低钾血症患儿的临床资料，根据补液治疗方法的不同分为3组，分别用以下液体补钾：1／2张含钠糖盐水、1／3张合钠糖盐水、1／4张含钠糖盐水。补钾浓度为0．3％的含钾液。比较3组不同的输入液体盐浓度和血钾上升快慢，病情恢复及预后。结果11例严重低血钾病人中，以1／2张含钠糖盐水补钾3例，第1天均好转，第2天1例因值班医生接到严重低钾报告后以10％纯糖水200mL补钾5mL，故补液张力降为1／4张，并于当天死亡，其余2例病人每天均有好转。以1／3张含钠糖盐水补钾4例，第1天好转2例，无变化2例，第2天、第3天3例好转，1例无变化；1／4张含钠糖盐水补钾4例，3天均无好转。3种不同张力的含钠糖盐水组的治疗效果有显著性差异，1／2张含钠糖盐水组治疗效果最优（x2=13．636，P〈0．05）。结论在严重低钾血症时，常合并代谢性碱中毒，应使用含盐较多液体以促进代谢性碱中毒的纠正，促进低钾的恢复。

Analysis of the curative effect of 11 infants with severe hypokalemia

Objective To analyze the diagnose, treatment and prognosis of infants with severe hypokalemia, so as to provide reference for clinical medication for infants with severe hypokalemia. Methods Retrospective analysis was conducted on the clinical data of 11 infants with severe hypokalemia admitted during the period of January 2010 to March 2013. They were divided into 3 groups according to different fluid infusion methods, 1/2 tension GNS, 1/3 tension GNS, and 1/4 tension GNS. The concentration of potassium supplement liquid was 0.3%. Three groups were compared in the concentrations of sodium of fluid infusion, the speed of potassium rise, the clinical progress and prognosis. Results All of the three cases with 1/2 tension GNS were improved at the first day. At the second day one case was given 1/4 tension GNS for report of severe hypokalemia, and it died. The other two cases recovered day after day. Four cases received 1/3 tension GNS, among which two cases were improved while the other two cases did not change at the first day. At the second and third day three cases were improved while the other one was not. Four cases were given 1/4 tension GNS, and they were not improved in three days. There was significant difference in curative effect among three groups, and the curative effect of the group with 1/2 tension GNS was best （X2 = 13. 636, P 〈 0.05 ）. Conclusion Severe hypokalemia is usually complicated with metabolic alkalosis, so liquid with more sodium should be given for accelerating the correction of metabolic alkalosis and recovering of low potassium.