急危重症诊治中疑难电解质异常的辨伪识真

Difficult Electrolyte Abnormalities in the Diagnosis and Treatment for Acute and Critically Ill Patients

介绍几种急危重症诊治中的疑难电解质异常现象及治疗方法,主要内容有脂肪超载综合征中的假性低钠血症,毛细血管渗漏综合征和抗利尿激素分泌异常综合征中的低钠血症,高血糖昏迷中的转移性低钠血症,高渗疗法时血清钠与渗透浓度间隙监测,高钾血症抢救措施,顽固性高钾血症中的低醛固酮血症,隐匿性中毒相关低钾血症和高钙血症时心电图特征性Osborn波,以减少临床误诊误治,为急诊医师提高危重病救治水平提供指导。

This paper discusses the diagnosis and treatment for several phenomenon of the difficult electrolyte abnormalities in acute and critically ill patients. The main contents include the fat overload syndrome with hyponatremia,hyponatremia in the capillary leak syndrome and syndrome of inappropriate antidiuretic hormone secretion,transferred hyponatremia in high blood sugar coma,monitoring of serum sodium and osmotic pressure gap for hypertonic treatment,hyperkalemia rescue measures using sequential,hypoaldosteronemia for the refractory hyperkalemia,hypokalemia associated with concealed poisoning,and hypercalcemia with ECG Osborn wave,which are instructive for reducing the misdiagnosis rate and improving the rescue level for critically ill patients.