大量输血导致血钾变化的相关分析

目的探讨大量输血与血清钾变化的相关性。方法回顾性分析2007年3月至2010年12月所有非挤压伤病人大量输血(观察组)和非输血患者(对照组)的临床资料,采用多因素分析方法分析输血前后血钾变化规律及影响因素。结果手术和输血前、后两组血清钾水平无显著差异(P>0.05),但术后12 h内观察组的高钾血症发生率高于对照组(P<0.05),而12 h后两组高血钾的发生率无显著差异(P>0.05)。Logistic回归分析显示术前高血钾(P<0.05)和术后低pH值(P<0.05)是导致术后高钾血症的主要原因,而与大量输血治疗无明显相关性(P>0.05)。结论非挤压伤病人大量输血并不是导致高钾血症的发生的直接原因,但同样需要动态监测输血前后的血钾变化。

Changes in plasma potassium levels following massive transfusion in trauma

Objective To explore the changes of plasma potassium levels and the impact factor of hyperkalemia following massive transfusion. Methods The clinical data of all non - crush trauma patients with massive transfusion treated in this hospital from March 2007 to December 2010 were retrospectively analyzed. Multivariate analysis was used to examine the effect of massive transfusion on plasma potassium level. Results There was no significant difference in plasma potassium level between study group and control group before and after blood transfusion and sur- gery （ P 〉0.05）. Although the incidence of hyperkalemia in study group was higher than that in control group during 12 h postoperation （ P 〈 0.05 ）, by 12 h there was no difference （ P 〉 0.05 ）. Logistic regression identifed only preoperative high K ＋ level （ P 〈 0.05 ） and postopera- tive lower pH （ P 〈 0.05 ）, but not massive transfusion, as independent risk factors for postoperative hyperkalemia. Conclusion Massive transfusion patients with non - crush trauma were at no higher risk of hyperkalemia than those who received no blood products, but we should detect the levels of plasma potassium dynamically following massive transfusion.