低钾型周期性麻痹急诊处理体会(附96例报道)

The Clinical Experience of Diagnosis and Treatment about Hypokalemic Periodic Paralysis(96 cases)

目的探讨低钾型周期性麻痹(hypokalemicperiodicparalysis.HOPP)的诱发因素、临床表现及诊治体会。方法回顾性分析96例HOPP患者的临床资料。结果发病前常有明显诱因,发病多在夜间睡眠中或凌晨清醒后。最早表现为四肢不同程度的迟缓性的肌无力,部分重度HOPP患者可并发心律失常及呼吸肌麻痹,急诊心电图检查发现所有病例均有典型T波改变。95例患者经静脉及口服补钾,配合安体舒通、硫酸镁治疗后症状完全缓解,1例重度患者死于休克和严重心率失常。结论对于HOPP,及早诊治是关键;而对于重度HOPP,心电监护、抗心率失常药物、抗休克治疗和呼吸机辅助呼吸是抢救成功的重要措施。

Objective To investigate the causes,clinical characteristics and treatments of hypokalemic Periodic paralysis（HOPP）. Methods The clinical data of 96 cases suffering from HOPP were analyzed and summarized retrospectively. Results There were inducement among mostly cases, and the symptoms happened mainly when sleeping or awaking in the morning. The classical appearance was sluggish myoasthenia of four limbs and hypokalemia,and some serious HOPP experienced respiratorypandysis and arrhythmia. There was typical alteration of T wave in emergency electrocardiography among all cases. The symptom of 95 cases relieved completely after given potassium by transfusion or orally, combinated with antisterone and magnesium sulfate, but 1 case died of cardiogenic shock and critical arrhythmia. Conclusions It is vital to diagnose and treat HOPP as early as possihle. As for serious HOPE The key measures are. electrocardio surveille, reversing critical arrhythmia, shock treatment and vantilatory support.