心电图检查在高血钾患者急诊抢救中的价值

The Value of Electrocardiogram in Patients with Hyperkalemia in Emergency Rescue

目的探讨心电图在高血钾患者急诊抢救中的价值。方法回顾性分析我院2009年1月至2011年2月在急诊抢救高血钾患者80例的心电图资料。结果心电图异常患者46例,诊断符合率为57.5%。其中,急/慢性肾功能不全为主27例(58.7%),其次是糖尿病7例(15.2%)。血清钾浓度5.0～7.0 mmol/L时,诊断符合率为27.3%。心电图表现为T波高尖,S波振幅增宽,P波振幅降低;血清钾浓度≥7.0 mmol/L时,诊断符合率为76.0%,心电图表现T波高尖、P-R间期延长、P波低平或消失、ST段下移、QRS波增宽。结论随着血清钾浓度的增高,心电图异常发生率增多,异常程度加重,心电图鉴别诊断高钾血症较假性高血钾测定更具有重要的临床价值。

Objective To investigate the value of electrocardiogram in patients with hyperkalemia in emergency rescue.Methods The clinical data of electrocardiograms in 80 patients with hyperkalemia in emergency rescue in our hospital from January 2009 to February 2011.Results There are 46 patients with abnormal electrocardiogram,the detective rate was 57.5%.Among them,acute or chronic renal insufficiency was 27 cases（58.7%）,then the diabetes in 7 cases（15.2%）.The level of serum potassium concentration was 5.0 to 7.0 mmol/L,the detective rate was 27.3%.High wave of sharp T,S wave-amplitude was broaded,P wave-amplitude was reduced by ECG feature..When the level of serum potassium was more than 7.0 mmol/L,the detective rate was 76.0%.T wave was tall,peaked and tended,P-R stage was extended,P wave was low amplitude or absent,and ST segment moved down,QRS complex widened by ECG feature.Conclusion With the level of serum potassium increased,the incidence of abnormal changes of electrocardiogram is higher,and is of clinical significance in distinguish hyperkalemia and pseudo-hyperkalemia.