不同含钾液对术中、术后兔血钾浓度影响的实验研究

Intravenous infusion of potassium chloride at different concentrations for correction of hypokalemia during perioperation: an experimental study

对40只家免于术中进行补钾观察,探讨了围术期钾代谢的动态变化与不同浓度含钾液对血钾的影响。结果表明,围术期是低钾发生的一个重要时期,在心、肾功能正常的情况下给予适当补钾有助于纠正低钾,改善机体缺钾现象,但过多补钾则不宜。围术期补钾浓度以含钾20～25mmol/L的平衡液10ml·kg^(-1)·h^(-1)的速度输入为宜,达到或超过50mmol/L将有引起高钾血症的危险。围术期低钾还与钾向骨骼肌与肝细胞内的转移密切相关。

A certain amount of potassium chloride is required to correct the hypokalemia occuring commonly during perioperation,but the overdosage may be harmful. To investigate the proper dose of KCl,40 adult rabbits were randomly and evenly assigned to be intravenously infused with normal saline(group Ⅰ),or saline containing 4,25 or 50 mmol/L KCI (group Ⅱ,Ⅲ,Ⅳ),at rate of 10 ml·kg^(-1)·h^(-1) during operation respectively. As compared with those before operation,the serum level of potassium decreased significantly in group Ⅰ and Ⅱ, changed unsignificantly in group Ⅲ,and increased in group Ⅳ during and after operation;the potassium amounts in liver and skeletal muscles increased markedly after operation. S-T segment was depressed in group Ⅰ and Ⅱ,T wave became peaked in group Ⅳ, and ECG remained normal in group Ⅲ. it is indicated that intravenous KCl infusion at concentration 25 mmol/L and rate of 10ml·kg^(-1)·h^(-1) may properly correct the hypokalemia during perioperation,and the occurance of perioperatine hypokelemia may be related to the uptake of liver and skeletal muscles