重症监护室肝硬化腹水患者合并电解质紊乱与预后的关系

The Relationship between Cirrhosis Ascites Combined with Electrolyte Imbalance and Its Prognosis

目的探讨肝硬化腹水患者合并电解质紊乱与预后的关系。方法选择2011年3月至2013年3月济宁市第一人民医院重症监护室收治的肝硬化腹水患者143例为研究对象,根据是否合并电解质紊乱以及电解质紊乱的严重程度分为未发生电解质紊乱组28例、轻度电解质紊乱组79例及重度电解质紊乱组36例,比较三组患者的预后情况。结果在合并电解质紊乱的115例患者中,单纯低钠血症34例(29.6%),单纯低钾血症31例(27.0%),低钠合并低钾血症19例(16.5%),低钠合并低氯血症14例(12.2%),低钠低氯合并低钾血症10例(8.7%),低钙低磷血症7例(6.1%)。未发生电解质紊乱组患者恶化/死亡患者比例与轻度及重度电解质紊乱组比较,差异均有统计学意义(P<0.05或P<0.01)。结论肝硬化腹水患者易并发电解质紊乱,以低钠血症以及低钾血症为主要类型,有效预防以及积极治疗电解质紊乱对于改善肝硬化腹水患者的预后有重要作用。

Objective To explore the relationship between cirrhosis ascites combined with electrolyte imbalance and its prognosis.Methods A total of 143 patients with cirrhosis ascites admitted in Jining First People′s Hospital from Mar.2011 to Mar.2013 were selected,and divided into electrolyte balance group （28 cases）,mild electrolyte imbalance group （79 cases） and severe electrolyte imbalance group （36 cases） according to their electrolyte imbalance level.The prognosis of the three groups was compared.Results In 115 cases complicated by electrolyte disorder,there were 34 cases （29.6%） of simple hyponatremia,31 cases of simple hypokalemia （27.0%）,19 cases （16.5%） of low sodium combined with hypokalemia,14 cases （12.2%） of low sodium with hypochloremia,10 cases of low sodium and chlorine with hypokalemia （8.7%）,7 cases （6.1%） of low calcium and phosphorus.Differences of the patient number of deterioration and death of electrolyte imbalance between electrolyte balance group and mild and severe electrolyte imbal-ance groups were statistically significant（P〈0.05 or P〈0.01）.Conclusion Patients with cirrhosis ascites is easily complicated by electrolyte imbalance,and the main types were hyponatremia and hypokalemia,effec-tive prevention and active treatment for electrolyte imbalance can improve the prognosis of cirrhosis ascites .