经中心静脉导管补充高浓度氯化钾治疗严重低钾血症

目的 分析经中心静脉置管使用微量泵高浓度快速补钾治疗EICU危重低钾血症患者的疗效及可行性.方法 将玉溪市人民医院2012年9月至2015年6月EICU收治的120例存在严重低钾血症患者随机分为实验组(高浓度补钾组)和对照组(常规浓度补钾组),2组患者分别采用不同浓度补钾方法进行补钾治疗,并每小时检测患者血钾浓度,比较2组患者血钾恢复至标准钾浓度(4.0 mmol/L)所需时间,以及24 h补钾所需液体量.结果 实验组血钾浓度恢复至4.0 mmol/L的时间为(12.83±3.57)h,24 h补钾所需液体量为(402.56±54.61)m L,对照组血钾浓度恢复至4.0 mmol/L的平均时间为(23.18±4.98)h,24 h补钾所需液体量为(2875.2±206.26)m L,2组补钾时间及24 h补钾所需液体量比较实验组均较对照组少(P<0.01).结论 对危重患者严重低钾血症应用微量泵中心静脉高浓度氯化钾治疗,其纠正低钾速度快,且不增加输液量,是一种安全、高效、可行的补钾方法,尤其适用于治疗EICU存在心脏容量负荷过重且合并严重低钾血症的危重患者,值得临床进一步研究推广.

Effects of Highly Concentrated Potassium Chloride via Central Venous Catheterization on Severe Hypokalemia

Objective To investigate the clinical effects and feasibility of highly concentrated Potassium Chloride via central venous catheterization by micro pump on severe hypokalemia patients in EICU. Methods A totlal of 120 severe hypokalemia patients in our department were randomly divided into experimental group(treated with highly concentrated Potassium Chloride) and control group(normal treatment group) respectively, and treated with Potassium Chloride liquid of different concentration. Potassium levels in blood were checked every hour and the time for reaching standard potassium level(4.0mmol/L) and the total volumes of infusion fluid within 24 hours in the two groups was compared. Results The mean time for reaching standard potassium level and the total volumes of infusion fluid within 24 hours in the experimental group,(12.83±3.57) h and(402.56±54.61) ml respectively, were significantly less than those in the control group(P <0.01),(23.18 ±4.98) h and(2875.2 ±206.26) ml respectively. Conclusion Highly-concentrated potassium chloride injection via central venous catheterization by micro-pump is a safe, effective and feasible treatment on the patients with severe hypokalemia, especially on the patients with volume-overloaded heart and severe hypokalemia, which is worthy of further clinical research.