血液透析患者高钾血症的临床分析

Clinical analysis of hyperkalemia in the hemodialysis patients

目的 对血液透析患者反复出现的高钾血症进行分析,强调积极防治的重要性。方法 分析523例血液透析患者反复出现高钾血症的病例。结合临床表现、血电介质和心电图,探讨发生高钾血症的病因和应采取的防治措施。结果发生高钾血症15例,占2.9％,共计38例次。发作时血钾6.0～7.7mmol/L,伴有低血钠、乏力、心律失常和心电图改变(T波高尖)。经紧急血液透析治疗后,高钾血症消失。结论在血液透析过程中反复出现高钾血症的原因可能为:摄入钾过多、酸中毒、低血钠和透析不充分间隔时间过长。应密切监测血钾的动态变化,消除病因,及时进行血透治疗。

Objective To analyze hyperkalemia occurring in the hemodialysis patients and emphasizing the impedance of positive management.Methods To discuss the parhogeny and management of hyperkelemia.by analyzing hyperkalemia occurring in 523 hemodialysis patients according to their clinical symptom, plasma electrolyte and ECG. Results The incidence of hyperkalemia occurring in the hemodialysis patients is 2.9% .The signs and symptoms of hyperkalemia include plasma K increasing to 6.0-7.7mmol/L and concomitance of hypanotremia.weakness.arrhythmia and ECG changes (peaked T waves) .Hyperkalemia was cleared away by emergent hemodialysis.Conclusions Hyperkalermia occurring in the hemodialysis patients is most often caused by excessive intake of potassium,acidosis, hypanotremia and inadequate hemodialysis.Management of hyperkalemia consists of continuous monitoring of potassium, eliminating the underlying condition and hemodialysing as soon as possible.