毛细血管渗漏综合征伴电解质紊乱诊治经验与教训

Analysis of Capillary Leak Syndrome with Electrolyte Disturbance(Experiences and Lessons)

目的分析毛细血管渗漏综合征(capillary leak syndrome,CLS)伴电解质紊乱的临床特点,以减少误诊误治。方法回顾分析我院收治的2例CLS的临床诊疗资料。结果 2例均以发热就诊,例1住院过程中先后2次出现低钠、低钾血症和缺氧症状,气管插管内吸出淡血色液体,予限制液体输入和输注羟乙基淀粉后缓解,随后病情恶化抢救无效死亡;例2也表现为气管插管内吸出大量淡血色液体合并缺氧、低钠和低钾血症,未限制液体输入和应用羟乙基淀粉,病情逐渐加重死亡。结论 CLS并电解质紊乱有其特殊性,盲目补充液体和电解质可加重病情。

Objective To explore the clinical characteristics of the capillary leak syndrome with electrolyte disturbance for reducing its misdiagnosis and mistreatment rate. Methods The clinical data of 2 patients with capillary leak syndrome in our hospital were retrospectively analyzed. Results Two patients were manifested as running a fever. One patient showed the two episodes of hyponatremia,hypokalemia,anoxemia and large pale blooded liquid from the brachial tube,and then was relieved after the liquid income control and hydroxyethyl starch,and the patient finally died after his condition deteriorated. The other patient was also found to have large pale blooded liquid from the brachial tube with anoxemia,hyponatremia and hypokalemia without using liquid income control and hydroxyethyl starch,but also died after all attempts failed. Conclusion The phenomenon of capillary leak syndrome with hyponatremia and other electrolyte disturbance has special characteristics,and giving the liquid and electrolyte randomly may worsen the patient＇s condition.