肺部感染患者输液后发生急性低血钾的影响因素调查

Influencing factors for acute hypokalemia in patients with pulmonary infection after infusion

目的探讨肺部感染患者输液后发生急性低血钾的影响因素,为肺部感染患者的临床诊治及输液时低血钾的预防提供参考。方法选取2017年1-6月医院诊治的300例肺部感染输液治疗患者为研究对象,检测患者输液3d时的血钾浓度,单因素及多因素Logistic回归分析引起患者急性低血钾的影响因素。结果输液后34例患者发生急性低血钾,发生率为11.33%,其中轻度21例、中度11例、重度2例,分别占61.77%、32.35%、5.88%;患者性别、氯化钠输液量、输液总量与患者发生急性低血钾无关(P>0.05),患者年龄≥60岁、体温≥38.5℃、高血压及冠心病、抗菌药物为青霉素及头孢类、葡萄糖输液量≥1000ml/d、应用糖皮质激素是输液后发生急性低血钾的影响因素(P<0.05);多因素Logistic回归分析显示高龄、葡萄糖输液量大、抗菌药物种类、应用糖皮质激素是引起急性低血钾发生的独立影响因素(P<0.05)。结论肺部感染患者输液后急性低血钾的发生率相对较高,主要以轻度为主,高龄、葡萄糖输液量大、抗菌药物种类、应用糖皮质激素时容易发生急性低血钾,输液时应注意补钾预防低血钾的发生。

OBJECTIVE To explore the influencing factors for acute hypokalemia in patients with pulmonary infection after infusion so as to provide guidance for clinical diagnosis and treatment of the patients with pulmonary infection and prevention of hypokalemia after infusion.METHODS A total of 300 patients with pulmonary infection who received infusion therapy from Jan 2017 to Jun 2017 were recruited as the study objects,the serum potassium concentration of the patients was detected on the 3 rd of infusion,and the univariate analysis and multivariate logistic regression analysis were performed for the influencing factors for the acute hypokalemia.RESULTS Totally 34 patients had acute hypokalemia after the infusion,with the incidence rate 11.33%,21(61.77%)of whom had mild hypokalemia,11(32.35%)had moderate hypokalemia,and 2(5.88%)had severe hypokalemia.The acute hypokalemia was not associated with gender,volume of sodium chloride infusion or total infusion volume(P>0.05).The no less than 60 years of age,body temperature no less than 38.5 ℃,hypertension,coronary heart disease,penicillin and cephalosporins,infusion volume of glucose no less than 1000 ml/d and use of glucocorticoids were the influencing factors for the acute hypokalemia after the infusion(P<0.05).The multivariate logistic regression analysis indicated that the advanced age,large infusion volume of glucose,types of antibiotics and use of glucocorticoids were the independent influencing factors for the acute hypokalemia(P<0.05).CONCLUSION The incidence rate of acute hypokalemia is relatively high in the patients with pulmonary infection after the infusion,the patients with mild hypokalemia are dominant.The patients with advanced age,large infusion volume of glucose and use of antibiotics and glucocorticoids tended to have the acute hypokalemia.It is necessary to attach great importance to the supplement of potassium so as to prevent the hypokalemia.