摘要
目的:探讨急诊心脏骤停(CA)患者高钾血症的发生及其与复苏结局的相关性,复苏结局主要考察指标为自主循环恢复(ROSC)与否。方法:回顾2017年2月至2018年3月急诊科CA患者检测动脉血气及电解质患者65例,统计血钾水平并分析不同血钾水平与ROSC率的关系。结果:超过一半的CA患者(37/65)在急诊心肺复苏(CPR)过程中监测到了高钾血症的发生;在不同血钾水平ROSC率方面,低血钾组为66.7%(6/9),正常血钾组为21.1%(4/19),高血钾组为13.5%(5/37),各组ROSC率的差异具有统计学意义(P=0.006)。进一步对各组ROSC率进行组间两两比较,结果显示,低血钾组与正常血钾组、正常血钾组与高血钾组的ROSC率没有统计学差异,P值分别为0.035和0.470,高血钾组与低血钾组的ROSC率相比,P值为0.003,差异有统计学意义。结论:在急诊CPR过程中高钾血症的发生十分常见,并且对复苏结局产生不利影响,需要关注并积极处理。
Objective:To investigate the occurrence of hyperkalemia in patients with cardiac arrest(CA)in emergency room and its correlation with the outcome of resuscitation as chiefly reflected by recovery of spontaneous circulation(ROSC).Methods:A retrospective analysis was performed for data on arterial blood gas and electrolytes from of 65 CA patients at an emergency department between February 2017 and March 2018.Blood potassium level was recorded,and the relationship between blood potassium levels and ROSC rates was analyzed.Results:Over half of CA patients(37/65)were noted to have hyperkalemia during emergency cardiopulmonary resuscitation(CPR).The rate of ROSC with different blood potassium levels was:66.7%(6/9)in the hypokalemia group,21.1%(4/19)in the normokalemia group,and 13.5%(5/37)in the hyperkalemia group,with statistical difference among groups(P=0.006).Between-group comparison of ROSC showed that there was no significant difference in the ROSC rate between the hypokalemia group and the normokalemia group or between the normokalemia group and the hyperkalemia group(P=0.035 and 0.470,respectively).There was a statistically significant difference in the ROSC rate between the hyperkalemia group and the hypokalemia group(P=0.003).Conclusion:Hyperkalemia is very common during emergency CPR and imposes an adverse effect on the outcome of resuscitation,which needs attention and pro-active treatment.
作者
肖利民
胡芳
丁章婷
Xiao Limin;Hu Fang;Ding Zhangting(Emergency Department,Caidian District People’s Hospital,Wuhan 430100,China)
出处
《广州医科大学学报》
2018年第5期44-47,共4页
Academic Journal of Guangzhou Medical University
关键词
急诊
心脏骤停
心肺复苏
高钾血症
碳酸氢钠
自主循环恢复
Emergency department
cardiac arrest
cardiopulmonary resuscitation
hyperkalemia
sodium bicarbonate
recovery of spontaneous circulation
