摘要
目的：探讨严重创伤患者大量输血后高钾血症的发生率及影响因素。方法：选择2013-01-2014-10进行大量输血的113例严重创伤患者为观察组,选取同期外伤无输血的120例患者为对照组。对2组患者手术前后血钾浓度进行水平测定,同时对高钾血症发生的影响因素进行分析。结果：①2组患者在年龄、性别及创伤方式等方面差异无统计学意义（P〉0.05）,在创伤程度上差异有统计学意义（P〈0.05）。② 2组患者手术前后血钾浓度差异无统计学意义（P〉0.05）;观察组术后高钾血症的发生率高于对照组（P〈0.05）;术后12h高钾血症发生率差异无统计学意义（P〉0.05）。③ Logistic多因素回归分析显示,大量输血与术后高钾血症无明显相关性（OR=0.64;95%CI：0.041～5.297;P〉0.05）,而术前高血钾和术后pH值降低是高钾血症的主要影响因素。结论：大量输血不能直接导致高血钾的发生,但仍有一定的高钾血症发生率,因此在输血过程中需动态监测血钾的变化。
Objective：To discuss hyperkalemia incidence and its influencing factors after massive blood transfusions in trauma patients.Method：A total of 113 trauma patients with massive blood transfusion were chosen as the observation group in our hospital between January 2013 and October 2014,and 120 trauma patients without blood transfusion as the control group.Potassium level before and after operation and postoperative 12 h were determined in two groups,and the influencing factors related hyperkalemia were analyzed.Result：①There were no statistical difference among age,gender,and way of trauma in two groups（P〉0.05）,and injury severity was statistically different in two groups（P〈0.05）.②Potassium level before and after operation and postoperative 12 h were not statistical different in two groups（P〉0.05）.The incidence of postoperative hyperkalemia in observation group was higher than that in control group（P〈0.05）.The incidences of postoperative 12 hhyperkalemia were not statistical different in two groups（P〉0.05）.③Massive blood transfusion had no significant correlation with postoperative hyperkalemia（OR=0.62;95% CI：0.040-5.306,P〈0.05）,and high preoperative potassium and postoperative lower pH was the main influencing factors of hyperkalemia.Conclusion：Massive blood transfusion did not lead directly to the occurrence of high potassium,but there was a certain incidence of hyperkalemia,therefore the change of potassium would need monitoring in the process of transfusion.
出处
《临床血液学杂志（输血与检验）》
CAS
2015年第5期847-849,共3页
Journal of Clinical Hematology(Blood Transfusion & Laboratory Medicine)
关键词
创伤
大量输血
高钾血症
影响因素
trauma
massive blood transfusion
hyperkalemia
affecting factors
