围手术期补钾理想时间探讨(附210例报告)

目的:探讨围手术期补钾理想时间.方法:回顾性分析近1年来210例手术前后病人血钾值及术后两组补钾不同时间和量的差别.结果:住院围手术期病人低钾血症发生率为28.1%,其中消化系疾病病人(37.6%)发生率高于非消化系疾病病人(20.5%),差异有统计学意义(p＜0.01);术中、术后48h内输血的低钾发生率(28.2%),与未输血者比较差异无统计学意义(p＞0.05);有低钾相关症状的患者血钾值低于正常的占56.5%,无临床表现的7例(6.4%),差异有统计学意义(p＜0.01);术后早期补钾者低钾发生率13.6%(6/44),早期不补钾者低钾发生率34.1%(14/41),差异有统计学意义(p＜0.05).结论:兼顾生理钾需要量基础上围手术期患者有低钾症状的需要早期足量补钾,有症状而血清钾数值仍在正常范围的也需补钾,尤其是消化系疾病手术后的病人手术当日即可补钾,输血者不应禁忌.

THE RIGHT TIME FOR POSASSIUM SUPPLEMENTATION IN PERIOPERATIVE CASES

OBJECTIVE:To determine the right time for potassium supplement in perioperative cases.METHOD:210 perioperative patients who were given potassium therapy over the last year were retrospectively analysed.RESULTS:The incidence rate of hypopotassaemia was 28.1% with patients of gastrointestinal disease 37.6%,significantly higher than that of non-gastrointestinal diseases(20.5%)(p<0.01);Difference of hypopotassaemia incidence between patients with blood transfusion during operation and postoperatively and those without bolld transfusion was not significant(p>0.05);Patients with hypopotassaemia symptom and had decreased serous potassium made up 56.5% and only 7 patients did not present clinical symptoms,which difference was statistically significant(p<0.01);Patients who were early given potassium therapy had much less incidence(13.6%)developing hypopotassaemia than those who did not give potassium at the early stage(34.1%)and the difference was significant(p<0.05);CONCLUSION:Early potassium supplement is necessary for perioperative patients who have physiological need of potassium.Patients with hypopotassaemia symptom but normal serous potassium level also need to supplement potassium.Postoperative patients of gastrointestinal diseases need potassium therapy at the of operation.Blood transfusion should not be the contraindication of potassium therapy.