急性化学物中毒性电解质失衡分级诊断讨论及中西医治疗方案分析  

Discussion on Grading Diagnosis of Acute Chemical Poisoning-Induced Electrolyte Imbalance and Analysis of Traditional Chinese and Western Medicine Treatment Protocol

作　　者：佟鑫 李宪 孙启东 Tong Xin;Li Xian;Sun Qi-dong(Department of Respiration,Jilin City Hospital of Chemical Industry,Jilin 132021,Jilin Province,China)

机构地区：[1]吉林市化工医院呼吸科,吉林吉林132021

出　　处：《中国社区医师》2023年第4期109-111,共3页Chinese Community Doctors

基　　金：吉林市医疗卫生指导性计划项目(编号:20220404002,20220404001)。

摘　　要：目的:对急性化学物中毒性电解质失衡分级诊断进行讨论,分析中西医治疗方案。方法:选取2020年1月1日-2021年12月31日吉林市化工医院收治的556例化学物中毒患者作为研究对象,总结其临床特点和中西医结合治疗经验,进行分级诊断讨论。结果:低钾血症是急性化学物中毒最常见症状,发生率为15.28%,556例患者低钾血症总发生率显著高于其他症状,差异有统计学意义(P<0.05);其次为低钠血症(发生率为10.61%),氯离子失衡(低氯血症发生率为6.29%、高氯血症发生率为6.83%),高钠血症(发生率为2.70%)和高钾血症(发生率为1.62%)比较少见。乙醇中毒和一氧化碳中毒最常见的电解质失衡情况是低钾血症,其发生率显著高于其他症状,差异有统计学意义(P<0.05);药剂中毒最常见的电解质失衡情况是低钠血症,其发生率显著高于其他症状,差异有统计学意义(P<0.05)。结论:电解质失衡是急性化学物中毒的常见并发症,急性化学物中毒性电解质失衡最常见的情况是低钾血症和低钠血症,建议将严重的离子紊乱情况作为急性化学物中毒的并发症看待,诊断分级主要依靠离子水平。Objective:To discuss the graded diagnosis of acute chemical poisoning-induced electrolyte imbalance,and analyze the traditional Chinese and western medicine treatment protocol.Methods:A total of 556 patients with chemical poisoning admitted to Jilin City Hospital of Chemical Industry from January 1,2020 to December 31,2021 were selected as the study subjects,and their clinical characteristics and treatment experience of integrated traditional Chinese and western medicine were summarized,and graded diagnosis was discussed.Results:Hypokalemia was the most common symptom of acute chemical poisoning,with an incidence rate of 15.28%,and the total incidence of hypokalemia in 556 patients was significantly higher than that of other symptoms,and the difference was statistically significant(P<0.05).Subsequently,hyponatremia(incidence 10.61%),chloride ions imbalance(hypochloremia incidence 6.29%,hyperchloremia incidence 6.83%),hypernatremia(incidence 2.70%) and hyperkalemia(incidence 1.62%) were less commonly observed.The most common electrolyte imbalance for ethanol poisoning and carbon monoxide poisoning was hypokalemia,the incidence was significantly higher than other symptoms,with a statistically significant difference(P<0.05);The most common electrolyte imbalance in pharmaceutical poisoning is hyponatremia,the incidence was significantly higher than other symptoms,with a statistically significant difference(P<0.05).Conclusion:Electrolyte imbalance is a common complication of acute chemical poisoning,the most common symptoms of acute chemical poisoninginduced electrolyte imbalance are hypokalemia and hyponatremia.It is suggested to treat serious ion disorder as a complication of acute chemical poisoning.The diagnosis grading mainly depends on ion level.

关 键 词：急性中毒 电解质紊乱 分级诊断 

分 类 号：R595[医药卫生—内科学]