高危低钾血症患者加速治疗专家共识(东湖共识)  

Expert consensus in accelerated treatment for patients with high-risk hypokalemia(East Lake Consensus)

作　　者：湖北省基层医学联盟 朱元州 尚游[3] 祝伟[4] 魏捷[5] 夏剑 甘泉 曹锋生[8] 赵慧[9] 蔡小芳[10] 杜宇[11] 瞿星光[12] 王冰[13] 王成 刘伯毅[15] 林彬[16] 孙昊[17] 岳茂兴 马静[19] 孙志辉 王斌 王夜明 常超[23] 刘欢 Primary Medical Union of Hubei Province;Zhu Yuanzhou;Shang You;Zhu Wei;Wei Jie;Xia Jian;Gan Quan;Cao Fengsheng;Zhao Hui;Cai Xiaofang;Du Yu;Qu Xingguang;Wang Bing;Wang Cheng;Liu Boyi;Lin Bin;Sun Hao;Yue Maoxing;Ma Jing;Sun Zhihui;Wang Bin;Wang Yeming;Chang Chao;Liu Huan(不详;Department of Cardiology,Liyuan Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430077,China;Department of Critical Care Medicine,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China;Department of Emergency Intensive Care,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China;Department of Emergency,Wuhan University People's Hospital,Wuhan 430060,China;Department of Emergency,Central South Hospital,Wuhan University,Wuhan 430062,China;Department of Adult Intensive Medicine,Hubei Maternal and Child Health Hospital,Wuhan 430064,China;Department of Emergency and Critical Care,Xiangyang Central Hospital,Xiangyang 441021,China;Department of Emergency,Hubei Maternal and Child Health Hospital,Wuhan 430064,China;Emergency Department of Wuhan Children's Hospital,Wuhan 430015,China;Department of Emergency and Critical Care,West China Fourth Hospital,Sichuan University,Chengdou 610041,China;Department of Critical Care Medicine,Yichang Central People's Hospial,Yichang 443008,China;Department of Intensive Care,Jingzhou Central Hospital,Wuhan 434020,China;Department of Emergency,Hainan Medical Colege Hospital,Haikou 570102,China;Department of Critical Care Medicine,Taihe Hospital,Shiyan 442000,China;Department of Emergency,the Third Affiliated Hospital to the Zhejang University of Traditional Chinese Medicine,Hangzhou 310005,China;Department of Emergeney,the First Afliated Hospital of Nanjng Medical University,Nanjing 210029,China;Trauma Center,Changzhou Second People's Hospital,Nanjng Medical University,Changzhou 213161,China;Department of Critical Care Medicine,Liyuan Hospital,Tongji Medical College,Huazhong University of

机构地区：[1]不详 [2]华中科技大学同济医学院附属梨园医院心内科,湖北武汉430077 [3]华中科技大学同济医学院附属协和医院重症医学科,湖北武汉430022 [4]华中科技大学同济医学院附属同济医院急诊重症科,湖北武汉430030 [5]武汉大学人民医院急诊科,湖北武汉430060 [6]武汉大学附属中南医院急诊科,湖北武汉430062 [7]湖北省妇幼保健院成人重症医学科,湖北武汉430064 [8]襄阳市中心医院急诊重症医学科,湖北襄阳441021 [9]湖北省妇幼保健院急诊科,湖北武汉430064 [10]武汉市儿童医院急诊科,湖北武汉430015 [11]四川大学华西第四医院急诊重症医学科,四川成都610041 [12]宜昌市中心人民医院重症医学科,湖北宜昌443008 [13]荆州市中心医院重症医学科,湖北荆州434020 [14]海南医学院附属医院急诊科,海南海口570102 [15]十堰市太和医院重症医学科,湖北十堰442000 [16]浙江中医药大学附属第三医院急诊科,浙江杭州310005 [17]南京医科大学第一附属医院急诊科,江苏南京210029 [18]南京医科大学附属常州第二人民医院创伤中心,江苏常州213161 [19]华中科技大学同济医学院附属梨园医院重症医学科,湖北武汉430077 [20]苏州高新区人民医院国际医学部,江苏苏州215129 [21]浙江省中医药大学附属第三医院急诊科,浙江杭州310005 [22]泰康同济医院重症医学科,湖北武汉430050 [23]邯郸市第一医院心内科,河北邯郸056002 [24]湖北省中西医结合医院急诊科,湖北武汉430010

出　　处：《中华卫生应急电子杂志》2023年第4期193-198,共6页Chinese Journal of Hygiene Rescue(Electronic Edition)

摘　　要：高危低钾血症属于临床急症,无论何种病因,均需积极纠正。常规补钾治疗需要3~4 d时间,病程中易发生恶性心律失常而危及患者生命。本共识针对低钾血症发生过程将其分为急性低钾血症、慢性低钾血症和慢性低钾血症急性发作三种情况,采取口服补钾为主,葡萄糖联合胰岛素加快血清钾转运到细胞内,达到尽快纠正高危低钾血症的目的,降低患者死亡风险,同时强调了补钾过程中出现低钙血症的处理,合并呼吸衰竭、心跳骤停的处理,反跳性高钾和常见补钾药物的特点,以规范高危低钾血症的加速治疗。High-risk hypokalemia is a clinical emergency,which needs to be actively corrected regardless of etiology.Routine potassium therapy takes 3-4 days,and malignant arrhythmia is prone to occurrence in the course of the disease,which endangers the life of the patients.This consensus classifies hyperkalemia into acute hyperkalemia,chronic hyperkalemia and acute exacerbation of chronic hyperkalemia,and adopts oral potassium supplementation as the mainstay,and glucose combined with insulin to accelerate the transfer of serum potassium into the cells to achieve the purpose of correcting high-risk hyperkalemia as soon as possible and to reduce the risk of death of the patients,and at the same time,the management of hypocalcemia during potassium supplementation,management of combined respiratory failure and cardiac arrest,rebound hyperkalemia and the characteristics of common potassium supplementation drugs are also emphasized.

关 键 词：低钾血症 加速治疗 

分 类 号：R591.1[医药卫生—内科学]