低钾性瘫痪40例临床分析

A Clinical Analysis of 40 Cases with Hypokalemic Paralysis

目的:探讨低钾性瘫痪的诊断及治疗。方法:分析40例低钾性瘫痪患者的一般情况、临床表现、辅助检查及诊断分型,并给予相应治疗。结果:40例低钾性瘫痪患者多为男性青壮年,多于夜间或晨起急性起病,四肢对称性软瘫,少数累及呼吸肌,发作时血清钾低,补钾后短期内恢复。20例原发性低钾性瘫痪者中1例为家族性,19例为散发性;20例继发性低钾性瘫痪者中2例为肾上腺皮质腺瘤,2例为肾小管性酸中毒,16例为甲亢。治疗应首选口服补钾,同时行病因治疗。结论:全面认识低钾性瘫痪的临床表现、诊断及治疗将会给低钾性瘫痪患者带来良好疗效。

Objective The diagnosis and treatment of hypokalemic paralysis were discussed. Methods： The general conditions, clinical manifestation, ancillary investigations, diagnostic classification and the therapy of 40 patients with hypokalernic paralysis were retrospectively assessed. Results： The attacks of hypokalemic paralysis tended to affect adolescent or middle-aged men. Each episode frequently occurred at night or in the morning. During attacks, the extremities were symmetrically paralyzed, with much less severe respiratory weakness. The seral potassium levels were decreased during attacks and shifted rapidly to normal range when supplemented by potassium chloride. One case was found to have a family history of the same disease out of 20 cases of primary hypokalemic paralysis. Two cases had adrenocortical tumor; 2 cases renal tubular acidosis, and 16 cases hyperthyroidism in the group. Oral KCL was the treatment of choice. At the same time, treating the etiology must be emphasized. Conclusion： Recognition of clinical manifestation, prompt diagnosis and reasonable treatment of hypokalernic paralysis will yield a satisfactory relief of attacks.