高钾血症144例病因及治疗临床分析

Clinical Analysis on Etiology and Cure in 144 Cases with Hyperkalemia

目的:探讨高钾血症的病因及治疗。方法:回顾性分析144例高钾血症患者的临床资料。结果:高钾血症主要原因是各种原因所致的急慢性肾功能衰竭,次要原因为代谢性酸中毒,及在补钾同时盲目应用保钾利尿药及血管紧张素转换酶抑制剂。少见原因有恶性肿瘤化疗后、烫伤、阿狄森氏病,高钾周期性麻痹等,假性高血钾亦较多见,应加以鉴别。结论:高血钾可能危及患者生命,应及时诊断积极处理,包括静推钙剂拮抗高血钾对心肌的抑制作用,同时采用清除血清中过多的钾及促进钾向细胞内转移的措施,停止一切钾的输入,治疗原发病及消除诱因。

Objective:To study the etiology and cure of hyperkalemia.Methods:The clinical data of 144 cases with hyperkalemia were retrospectively analysed. Results: The major etiological factors causing hyperkalemia are acute and chronic renal failure. Other factors are metablic acidosis and potassium-sparing diuresis or ACEI taken unchecked when kalium is supplimented. There are still some factors such as chemotherapy, scald, Addison' s disease, hyperkalemic periodic paralysis, etc. Conclusion: Hyperkalemia may endanger the patient' s lives. So it should be treated promptly and vigorously, for instance, intravanous injection of cacium to release the inhibition to cardiac muscle from hyperkalemia. At the same time such measures should be taken: to remove excess kalium from serum, improve kalium transport into cells, stop input of kalium, treat primary diseases and eliminate precipitating factors.