96例婴幼儿Ⅱ～Ⅲ度营养不良电解质紊乱分析

Clinical Analysis on Electrolyte Imbalance in 96 Infants with Ⅱ～Ⅲ Malnutrition

目的了解婴幼儿中重度营养不良的电解质紊乱的情况,以探讨临床合理治疗。方法对96例Ⅱ～Ⅲ度营养不良患儿的电解质进行回顾性分析,并根据其并发症分为肺炎组、腹泻组和混和组,进行对比分析。结果电解质紊乱以低血钾、低血钠为主,分别占60.4%、55.2%。其余依次为低氯血症(46.9%)、低钙血症(40.6%)、低镁血症(32.3%)、代谢性酸中毒(30.2%)和代谢性碱中毒(16.6%)。结论低血钠多见于并发肺炎者,低血钾多见于并发腹泻者。血氯多随钾钠的改变而改变。低血镁、低血钙亦常见,但却易受酸、碱中毒影响。酸中毒以代谢性为主,多见于并发腹泻患儿,脱水严重时有出现代谢性碱中毒的倾向。

Objective To study the status of electrolyte imbalance in infant with moderate to severe malnutrition and discuss reasonable clinical therapy. Methods we examined serum level of electrolyte and analyse retrospectively. 96 infants were divided into three group - pneumonia, diarrhea and mixed group, difference of electrolyte imbalance was compared within the three groups. Results Hypokalemia and hyponatremia were the major electrolyte imbalamce. 60.4% had hypokalemia, 55,2% had hyponatremia; the other imbalance, 46. 9% had hypochloremia, 40.6% had hypocalcemia, 32.3% had hypomagnesemia, 30.2% had metabolic acidosis and 16.6% had metabolic alkalosis. Conclusions The pneumonia group was more likely to have hyponatremia, and the diarrhea group was more likely to have hypokalemia. Serum level of chloride fluctuated with the change of blood potassium. Hypomagnesemia and hypocalcemia were normal and were influenced by acid - base balance. Acidosis was more likely to be found in diarrhea group, and was metabolic in most situation. There was a trend of emerging metabolic alkalosis in severe dehydration patient.