血清钾危急值的评价研究

A Study on Evaluation of Critical Value of Serum Kalium

目的探讨建立血清钾危急值报告制度的临床意义。方法回顾分析我院检验科2012年1—6月血清钾检测资料,以3.0 mmol/L为低血钾危急值界限值,6.0 mmol/L为高血钾危急值界限值,对报告的血清钾危急值患者进行临床追踪随访,记录患者分布情况,以及住院患者血清钾浓度分布情况、不同程度高钾血症及低钾血症患者的病死率、临床医生采取干预措施的时间。结果 114 871例次检测中共有2240例次(1.95%)血清钾检测达危急值,以住院患者为主。其中血清钾低危急值患者617例,高危急值患者201例,共死亡120例,病死率10.51%,低、高钾血症患者中分别以血清钾<2.50 mmol/L和>6.50 mmol/L者病死率最高;且低钾或高钾程度越严重的患者临床医生给予有效干预措施的时间越短。结论建立血清钾危急值报告制度对危险性电解质紊乱的临床救治、改善患者预后有重要意义。

Objective To investigate the clinical significance of establishing the reporting system of critical value of serum kalium. Methods Serum kalium results from our laboratory between January and June 2012 were reviewed retrospectively by using criteria of≤3. 0 mmol/L as low critical value and≥6. 0 mmol/L as high critical value. The hospitalized patients with reported critical value of serum kalium were all followed up for clinic, and their department distribution, distributed situation of serum kalium concentration, mortality rate of varying degree of hyperkalemia or hypokalemia and the time of starting treatment were all recorded. Results A total of 2240 in 114 847 （1. 95%） results were at critical value, which were mainly from inpatients. There were 617 patients with low critical value of serum kalium and 201 patients with high critical value of serum kalium. A total of 120 patients died （10. 51%）, and the mortality rate was high in patients with serum kalium lower than 2. 50 mmol/L or higher than 6. 50 mmol/L. The results showed that the more serious hypokalemia or hyperkalemia was, the shorter the time for clinicians responding to the critical results was. Conclusion Establishing a reporting system of critical value of serum kalium in laboratory has important significance to clinical treatment for serious electrolyte disorder and prognosis improvement.