中毒患者洗胃后血清电解质异常的临床分析  

Clinical analysis of serum electrolyte disturbance in the poisoning patients treated with gastric lavage

作　　者：马天龙[1] 黄培培[1] 张劲松[1] 孙昊[1] 乔莉[1] 陈旭锋[1] 

机构地区：[1]南京医科大学第一附属医院急诊中心,南京210029

出　　处：《临床急诊杂志》2017年第4期245-247,252,共4页Journal of Clinical Emergency

基　　金：江苏省科技项目(No:BL2014088)

摘　　要：目的:探讨口服中毒患者洗胃治疗后血清电解质异常发病的相关因素。方法:回顾分析我院2015-06-2016-12收治的给予清水洗胃的147例中毒患者临床资料。结果:洗胃后血清电解质异常的发病率为71.43%,其中钾离子37.41%、钠离子26.53%、氯离子23.81%、钙离子27.89%。147例中毒患者的28d病死率为42.18%,死亡组和存活组患者白细胞计数、中性粒细胞计数、血红蛋白、血清钾离子浓度、尿素氮、肌酐比较差异有统计学意义(P<0.05),其中死亡组中重度低钾血症的发病率(29.03%)大于存活组(4.71%)。洗胃液量(GV)<20L组血清钾离子浓度大于GV≥20L组(P<0.05)。结论:中毒患者洗胃后较易发生血清电解质的异常,以血清钾离子最为多见,尤其在GV≥20L时。Objective：To investigate the related factors of serum electrolyte derangement after gastric lavage （GL） in oral poisoning patients. Method： The clinical data of 147 patients treated with GL in our hospital were ana- lyzed retrospectively. Result： The incidence of serum electrolyte derangement was 71. 43% after GL, including 37.41% potassium ion,26.53% sodium ion,23.81% chloride ion and 27.89% calcium ion. Total 28 d mortality rate was 42.18 %. The white blood cell count, neutrophil count, hemoglobin, serum potassium concentration, blood urea nitrogen and serum creatinine in death group and survival group were significantly different （P〈0. 05 ,respec- tively）. The incidence of moderate to severe hypokalemia （K〈3.0 mmol/L） in death group （29.03%） was higher than that in survival group （4.71%）. The serum potassium concentration in the GV〉20 L group was higher than that in the GV〉20 L group （P〈0.05）. Conclusion：The serum electrolytes derangement are more likely to occur after GL in patients with poisoning, and lectrolyte disorders are more common in serum potassium, especially when GV〉20 L.

关 键 词：中毒 洗胃 电解质 低钾血症 

分 类 号：R595[医药卫生—内科学]