高钾血症管理规范——多科室合作全流程管理模式

Standard for the management of hyperkalemia—whole-process management mode of multi-department cooperation

高钾血症是临床常见的离子代谢紊乱之一,国内外指南将血钾高于5.0 mmol/L定义为高钾血症。急性重度高钾血症可引起弛缓性麻痹、致死性心律失常,甚至心脏停搏等严重后果。肾素-血管紧张素-醛固酮系统抑制剂、β受体阻滞剂、保钾利尿剂的应用,低钠高钾饮食以及相关合并症的存在均增加了高钾血症的发生。临床各科室均存在高钾血症风险人群,但缺乏医院多科室合作管理模式。为此,国内多位肾内科、心内科等领域专家讨论高钾血症医院多科室防治模式,制定了院内评估、预警、诊疗及管理规范流程,从而促进各科室更有效地参与院内高钾血症的诊疗以及慢性高钾血症的长期管理,提高全院高钾血症管理质量。

Hyperkalemia is one of the common ion metabolism disorders in clinical practice.Hyperkalemia is defined as serum potassium higher than 5.0 mmol/L according to the guidelines at home and abroad.Acute severe hyperkalemia can cause serious consequences,such as flaccid paralysis,fatal arrhythmia,and even cardiac arrest.The use of renin-angiotensin-aldosterone system inhibitors,β-blockers and diuretics,low-sodium and high-potassium diets,and the presence of related comorbidities increase the occurrence of hyperkalemia.Hyperkalemia risk exist in all clinical departments,but there is a lack of a standardization in the management of multi-department cooperation in hospital.Therefore,a number of domestic nephrology and cardiology department experts have discussed a management model for multi-department cooperation in hyperkalemia,formulating the management standard on hospital evaluation,early warning,diagnosis and treatment,and process.This can promote each department to more effectively participate in nosocomial hyperkalemia diagnosis and treatment,as well as the long-term management of chronic hyperkalemia,improving the quality of hyperkalemia management in hospital.