高钾血症管理规范——多科室合作全流程管理模式  

Standard for the management of hyperkalemia—whole-process management mode of multi-department cooperation

作　　者：叶智明[1] 蔡建芳 陈崴[3] 程虹[4] 何强[5] 李荣山[6] 李湘民[7] 廖新学[8] 毛志国 毛慧娟[10] 谭宁[11] 徐钢[12] 詹红[13] 张浩[14] 张健[15] 余学清 Ye Zhiming;Cai Jianfang;Chen Wei;Cheng Hong;He Qiang;Li Rongshan;Li Xiangmin;Liao Xinxue;Mao Zhiguo;Mao Huijuan;Tan Ning;Xu Gang;Zhan Hong;Zhang Hao;Zhang Jian;Yu Xueqing(Department of Nephrology,Guangdong Provincial People's Hospital,Guangzhou 510030,China;Department of Nephrology,National Center for Cardiovascular Disease&Chinese Academy of Medical Sciences&Peking Union Medical College&Fuwai Hospital,Beijing 100037,China;Department of Nephrology,the First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080,China;Department of Nephrology,Beijing Anzhen Hospital Affiliated to Capital Medical University,Beijing 100011,China;Department of Nephrology,Zhejiang Province People's Hospital,Hangzhou 310014,China;Department of Nephrology,Shanxi Provincial People's Hospital,Taiyuan 030000,China;Department of Emergency,Xiangya Hospital,Central South University,Changsha 410013,China;Department of Cardiology,the First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080,China;Department of Nephrology,the Second Affiliated Hospital of Naval Medical University,Shanghai 200003,China;Department of Nephrology,Jiangsu Provincial People's Hospital,Nanjing 210029,China;Department of Cardiology,Guangdong Provincial People's Hospital,Guangzhou 510030,China;Department of Nephrology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China;Department of Emergency,the First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510080,China;Department of Nephrology,the Third Xiangya Hospital,Central South University,Changsha 410013,China;Department of Cardiology,Peking Union Medical College&Fuwai Hospital&Chinese Academy of Medical Sciences&National Center for Cardiovascular Disease&Heart Failure Center&Heart Failure Intensive Care Unit,Beijing 100037,China)

机构地区：[1]广东省人民医院肾内科,广州510030 [2]中国医学科学院、北京协和医学院、国家心血管病中心、阜外医院肾内科,北京100037 [3]中山大学附属第一医院肾内科,广州510080 [4]首都医科大学附属北京安贞医院肾内科,北京100011 [5]浙江省人民医院肾内科,杭州310014 [6]山西省人民医院肾内科,太原030000 [7]中南大学湘雅医院急诊科,长沙410013 [8]中山大学附属第一医院心内科,广州510080 [9]海军军医大学第二附属医院肾内科,上海200003 [10]江苏省人民医院肾内科,南京210029 [11]广东省人民医院心内科,广州510030 [12]华中科技大学同济医学院附属同济医院肾内科,武汉430030 [13]中山大学附属第一医院急诊科,广州510080 [14]中南大学湘雅三医院肾内科,长沙410013 [15]北京协和医学院、中国医学科学院阜外医院、国家心血管病中心、心力衰竭中心、心衰重症监护病区,北京100037

出　　处：《中华肾脏病杂志》2024年第3期245-254,共10页Chinese Journal of Nephrology

摘　　要：高钾血症是临床常见的离子代谢紊乱之一,国内外指南将血钾高于5.0 mmol/L定义为高钾血症。急性重度高钾血症可引起弛缓性麻痹、致死性心律失常,甚至心脏停搏等严重后果。肾素-血管紧张素-醛固酮系统抑制剂、β受体阻滞剂、保钾利尿剂的应用,低钠高钾饮食以及相关合并症的存在均增加了高钾血症的发生。临床各科室均存在高钾血症风险人群,但缺乏医院多科室合作管理模式。为此,国内多位肾内科、心内科等领域专家讨论高钾血症医院多科室防治模式,制定了院内评估、预警、诊疗及管理规范流程,从而促进各科室更有效地参与院内高钾血症的诊疗以及慢性高钾血症的长期管理,提高全院高钾血症管理质量。Hyperkalemia is one of the common ion metabolism disorders in clinical practice.Hyperkalemia is defined as serum potassium higher than 5.0 mmol/L according to the guidelines at home and abroad.Acute severe hyperkalemia can cause serious consequences,such as flaccid paralysis,fatal arrhythmia,and even cardiac arrest.The use of renin-angiotensin-aldosterone system inhibitors,β-blockers and diuretics,low-sodium and high-potassium diets,and the presence of related comorbidities increase the occurrence of hyperkalemia.Hyperkalemia risk exist in all clinical departments,but there is a lack of a standardization in the management of multi-department cooperation in hospital.Therefore,a number of domestic nephrology and cardiology department experts have discussed a management model for multi-department cooperation in hyperkalemia,formulating the management standard on hospital evaluation,early warning,diagnosis and treatment,and process.This can promote each department to more effectively participate in nosocomial hyperkalemia diagnosis and treatment,as well as the long-term management of chronic hyperkalemia,improving the quality of hyperkalemia management in hospital.

关 键 词：高钾血症 跨部门合作 组织和管理 管理信息系统 多科室合作 全流程管理 

分 类 号：R589.4[医药卫生—内分泌]