5·12汶川大地震挤压综合征伤员电解质紊乱特点分析

Characteristics of electrolyte imbalance in victims suffered from crush syndrome in 5·12 Wenchuan earthquake

目的探讨汶川地震挤压综合征伤员电解质紊乱的特点。方法对149例地震挤压综合征伤员的临床特点,尤其是电解质紊乱的特点进行分析。结果与非挤压综合征伤员比较,149例(8.2%)挤压综合征伤员有更严重的肾功能损害,血钾及血磷水平更高,血钙水平更低(P<0.05);同时表现出血清天冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)和肌酸激酶(CK)水平显著升高(P<0.05);电解质紊乱表现多种多样,包括高钾血症、低钾血症、低钠血症、低钙血症、高磷血症、低磷血症以及代谢性酸中毒,尤其是高钾血症,不但严重而且顽固,需要尽早积极治疗。结论地震后挤压综合征伤员表现出严重而且复杂的电解质紊乱,高钾血症是最严重的表现,需要密切监测和积极治疗。

Objective In catastrophic earthquakes,many victims suffered from crush syndrome （CS）. There were many kinds of complications and the electrolyte imbalance was the most severe complication in these patients with CS. Here we reported the clinical characteristics of the patients with CS in the Wenchuan earthquake. Methods The questionnaires containing 96 clinical and laboratory items were completed in 1827 patients with seismic injury. We evaluated the clinical features of CS and electrolyte disorders in CS patients and non-CS patients. Results Totally 149 patients （8.2%） were diagnosed as crush syndrome. The patients with CS had many severe complications. They had various kinds electrolyte disturbances,including hyperkalemia,hypokalemia,hyponatremia,hypocalcemia,hyperphosphatemia,hypophosphatemia,and acidosis. The hyperkalemia,a life-threatening and refractory complication,needed intensive treatment. Conclusions The patients with CS often have severe and complicated electrolyte disturbances. The hyperkalemia is a life-threatening complication which should be treated intensively.