摘要
目的 探讨对于严重低钾血症 (K+ <2 5mmol/L)进行快速高浓度补钾目标性治疗策略的指征、疗效和安全性。方法 对于严重低钾血症 ,按 0 3～ 0 5mmol/(kg·h)的速度静脉输入补钾。将 15 %的氯化钾溶液用注射用水或 5 %葡萄糖液稀释成 0 3 %～ 1 5 %浓度 ,用输液泵均匀输入。当血钾 >3 0mmol/L改为常规补钾治疗。持续心电监护和经皮氧饱和度监护 ,补钾前查血钾、血气分析和心电图 ,快速补钾后每小时监测微量血钾。 结果 共 11例 ,14例次目标性补钾 ,补钾开始时血钾浓度1 8～ 3 0mmol/L ,平均 2 5 1mmol/L ,补钾持续时间 1～ 8 5小时 ,平均 6 64小时。钾绝对入量 4～ 5 0mmol/L ,平均 16 5mmol/L。静脉补钾液的浓度 0 3 %～ 5 1% ,平均 0 97%。输钾速度 0 3 0～ 0 5 8mmol/(kg·h) ,平均 0 44mmol/(kg·h)。微量生化血钾增长值 0 13～ 1 83mmol/L ,平均 0 68mmol/L ,每小时平均增长 0 10 3mmol/L。持续心电监护未发现任何与一过性血钾升高有关的心律紊乱。 结论 快速高浓度补钾目标性治疗策略 ,对于严重低钾血症治疗安全有效。
Objective To investigate the indication,effect and safety of rapid administration of high concentration potassium solution for severe hypokalemia(k\++<2\^5 mmol/L).Methods Severely ill patients with hypokalemia in PICU were given potassium 0\^3～0\^5 mmol/(kg·h) intravenously.Dilute 15%kalii chloridi with DDW or 5% glucose into concentration of 0\^3%～1 5%,then infuse with pump constantly.When serum potassium>3\^0 mmol/L,changing to regular treatment.Monitor cardiac function and transcutaneous oxygen saturation;investigate serum potassium,blood gas and EKG before treatment and serum potassium after treatment.Conclusion 14 times of target treatment were given to 11 cases. The initial serum potassium was 1\^8～3\^0 mmol/L(av 2\^51 mmol/L).6 of 14 with k\++<2\^5 mmol/L(42\^8%).The treatment maintained 1～8\^5 hr (av 6\^64 hr).The volume of potassium was 4～50 mmol(av 16\^5 mmol).The concentration of potassium solution was 0\^3%～5\^1%(av 0\^97%).The rate of k\++ infused was 0\^3～0\^58 mmol/(kg·h),av 0\^44 mmol/(kg·h).Serum potassium was increased to 0\^13～1\^83 mmol/L(av 0\^68 mmol/L).So the increasing rate of serum potassium was 0\^103 mmol/(L·h) in average.No arrhythmia was detected.Results Rapid administration of high concentration potassium solution was safe and effective for severe hypokalemia.
出处
《小儿急救医学》
2000年第2期73-74,共2页
Pediatric Emergency Medicine
