直肠癌患者手术前血钾浓度变化的分析  

Analysis of the changes of serum potassium concentration before operation in rectal cancer patients

作　　者：叶辉[1] 龚治林[1] 周启昌[1] 于杰[1] 黄淑娟[1] 郗昌磊 曹龙磊 

机构地区：[1]华中科技大学同济医学院附属荆州医院肛肠外科,湖北荆州434020

出　　处：《国际外科学杂志》2016年第2期103-106,共4页International Journal of Surgery

基　　金：荆州市科技发展计划项目（2014037）

摘　　要：目的观察直肠癌患者人院至手术前血钾浓度的变化，为预防直肠癌患者术中及术后血钾紊乱提供临床证据。方法分3个时间点监测40例直肠癌患者白人院至手术之前的血钾浓度变化，即入院第一天、服用泻药前、手术当天早晨，并根据患者年龄（低龄组、中龄组、高龄组）、性别（男性组、女性组）、饮食状况（饮食正常组、饮食稍下降组、饮食严重下降组）、病程（长病程组、中病程组、短病程组）进行分组，观察各时间点之间及各组之间血钾浓度，使用SPSS13．0统计软件进行统计分析。结果所有患者血钾浓度平均值入院第一天为（4．09±0．62）mmol／L，服用泻药前为（3．83±0．46）mmol／L，较人院第一天有所下降，差异有统计学意义（P〈0．01），手术当天早晨为（3．36±0．40）mmol／L，与前两次均有统计学差异（P〈0．01）；不同性别之间各时间点血钾浓度差异无统学意义（P〉0．05）；不同年龄组除低龄组与高龄组在手术当天早晨血钾浓度差异有统计学意义（P〈0．05）外，其他年龄组在不同时间点之间血钾浓度差异无统计学意义（P〉0．05）；不同饮食状况组、不同病程组在各时间点之间差异均有统计学意义（P〈0．01）。结论直肠癌患者手术之前即可能处于低钾血症状态，其原因可能与患者病程长、饮食量下降、年老体弱、入院后饮食结构改变及服用泻药清洁肠道相关。Objective To observe the changes of serum potassium concentration in rectal cancer patients from the admission to before the operation, to provide clinical evidence for preventing serum potassium disorder during and after their operation. Methods Monitoring of the changes of serum potassium concentration of 40 cases of rectal cancer patients according to three time points including the first day of admission, before taking of cathartics and the morning before operation. They were divided into different groups according to their age（ young, middle age and elderly group） , gender（ male and female group） , diet（ normal, decreased slightly and serious decline group） alld course（ long, middle and short course group） of disease. The serum potassium concentration was observed between each time point of each group and SPSS13.0 statistical software was used to analyze the changes above. Results The mean of all patients＇ serum potassium concentration was （4.09± 0.62） mmol/L on the first day of admission, was （3.83 ± 0.46） mmol/L before taking of cathartics that was decreased compared to the former and there was significant difference （P 〈 0.01 ）, it was （3.36 ±0.40） mmol/L on the morning of operation and had significant difference with the above two groups （P 〈 0.01 ）. It hadn＇t significant difference between different gender and age groups at different time points （ P 〉 0.05 ） except between the young group and the elderly group in the morning of the operation （P 〈 0.05 ）. There were statistically significant differences between the different diet condition and different course at anytime point （P 〈 0. 01 ）. Conclusions The rectal cancer patients were possiblely in hypokal- emia before operation, the causes might be relative to the long course of disease, the decreased diet, the aged and infirm, the diet structure change after admission and taking cathartics cleaning intestinal tract.

关 键 词：直肠肿瘤 血钾浓度 分析 泻药 低钾血症 

分 类 号：R735.37[医药卫生—肿瘤]