高浓度快速静脉补钾纠正重症低钾血症(附31例报告)

Correction of Severe Hyperkalemia by Using Intravenous Infusion of Concentrated Potassium Chloride

目的探讨对重症低钾血症 (<2.1mmol/L)患者使用高浓度快速静脉补钾的安全性及有效性。方法在心电图、血钾监测下 ,用浓度100～800mmol/L(即0.8%～6 % )的氯化钾溶液以25～40mmol/h的速度经外周静脉输注来纠正伴软瘫及不同程度心律失常的重症低钾血症共31例。结果采用此法本组病人均在4～9小时内血钾上升到3.5mmol/L以上 ,心律失常消失 ,四肢肌力基本恢复。发生1例高钾血症 ,2例静脉炎 ,未发现致命性心律失常。结论高浓度快速静脉补钾的方法在严密监护下用以纠正重症低钾血症是安全有效的。

Objective To explore the safety and clinical efficacy of napid intravenous infusion of concentrated potassium chloride in patients with severe hypokalemia (less than 2.1 mmol/L). Methods 31 severe hypokalemia cases were intravenously infused with 100 ～ 800mmol/L potassium chloride at the speed of 25 ～40 mmol/h via a peripheral venous route so as to correct the severe hypokalemia associated with muscular paralysis and cardiac arrhythmia. Results By using the present method, all of the cases had increased serum potassium level of over 3.5mmol/L within 4 to 9 hours. The arrhythmia disappeared with improved muscular tone. One case had hyperkalemia and another two cases had phlebitis. No fatal arrhythmias were observed. Conclusion Under careful monitoring, it was safe and effective to infuse concentrated potassium for the quick correction of hypokalemia.