重度低钾血症静脉高浓度快速补钾的循证护理  

Evidence-based nursing of rapid concentrated intravenous potassium chloride infusions in a patient with severe hypokalemia

作　　者：李蓉[1] 王世平[1] 

机构地区：[1]四川大学华西医院,成都市610041

出　　处：《中华护理杂志》2009年第11期973-975,共3页Chinese Journal of Nursing

摘　　要：目的为1例肝移植术后发生盆腔脓肿伴重度低钾血症的围手术期患者制订合理的静脉高浓度快速补钾的治疗及护理方案。方法在充分评估患者病情的基础上,提出临床问题并转换成便于检索的形式,检索Cochrane图书馆、MEDLINE(1950-2008)、PubMed、CBM和CNKI数据库。结果检索出有关低钾血症采用静脉高浓度快速补钾治疗及护理的临床指南1篇,随机对照试验5篇,临床研究3篇。根据检索结果,并根据患者病情和患者及家属的意愿,为患者制订合理的静脉高浓度快速补钾方案:10%氯化钾溶液45ml加0.9%氯化纳溶液5ml经锁骨下中心静脉用微量泵以3-5ml/h的速度输注。经过20h的抢救治疗及护理,患者血钾水平恢复正常,顺利进行了盆腔脓肿清除、肝断面引流术。结论采用循证医学的方法可为重症低钾血症患者提供安全有效的治疗方案。Objective To formulate an evidence-based therapeutic and nursing plan of rapid concentrated potassium chloride infusions for a critically ill patient with hypokalemia and pelvis abscess after liver transplantation. Methods Based on an adequate assessment of the patient＇s condition,the clinical questions were proposed and the references were searched in a series of databases,such as Coehrane Library,MEDLINE （1950-2008）,PubMed,CBM and CNKI. Results One guideline,five randomized controlled trails and three clinical researches about rapid infusions of concentrated potassium chloride were searched out. Based on the references,the patient＇s clinical condition and the family members＇ wills,a reasonable therapeutic and nursing plan was formulated.The injection containing 45ml of 10% potassium chloride and 5ml of 0.9% sodium chloride was infused through subclavian vein at the speed of 3-5ml/h. Twenty hours later,the patient＇s hypokalemia was corrected. Consequently,the pelvis abscess was eliminated and waste matters were drained from the liver. Conclusions Evidence-based approaches is helpful for rapid correction of hypokalemia.

关 键 词：低钾血症 氯化钾 输注 静脉内 护理 循证医学 

分 类 号：R473.5[医药卫生—护理学] R47[医药卫生—临床医学]