心肺复苏后血电解质紊乱  

Serum Electrolyte Disturbance after Cardiopulmonary Rasuscitation.

作　　者：李利华[1] 贾菱[1] 孔江[1] 朱新华[1] 李玉范[1] 

机构地区：[1]中国人民解放军总医院急诊科,北京100853

出　　处：《急诊医学》1992年第2期84-85,共2页

摘　　要：心搏骤停前无酸碱及电解质紊乱病因及证据之患者22例,自主循环恢复后3小时内有低血钾者12例(54.5%),低血钠2例(9%)。低血钾组之pHa为7.266±0.045,正常血钾组为7.294±0.048(P>0.05)、无1例有碱中毒表现。血钾浓度与复苏时肾上腺素用量及恢复自主循环(ROSC)时间长短之间无直线相关(r分别为0.139及0.168),提示复苏后低血钾并非碱中毒引起,它与外源性使用肾上腺素也无关。作者认为复苏后早期低血钾可能系复苏时机体内源性肾上腺素释放增加使K+再分布进入细胞内所致。低血钾组与正常血钾组之CPCR成功率无显著性差异(58.3%对50%,P>0.05),提示复苏后低血钾与随后之死亡的死亡率无关。严重低血钾(<0.3mEq/L)患者,尤其是原有心脏病者,因有严重心律失常甚至再发室颤之可能,应引起重视。The serum electrolyte were measured after return of spontaneous circulation in 22 patients with cardiac arrest not due to kidney, pulmonary or metabolic disease. The result showed that as early as within three hours after ROSC hypokalemia were found in 12 cases (54.4%) and hyponatremia in 2cases(9%). The mean value of pHa was 7.266±0.045 in patients with hypokalemia and 7.294±0.048 in patients with normalkalemia, no alkalosis was occured. The concentration of serum potassium were not correlated with the doses of epinephrine nor the time needed for ROSC (r was 0.139 and 0.168 respectively). It indicated that hypokalemia after CPR is not caused by alkalosis or exogenous epinephrine. It is proposed that this may be due to K^+ transfered into cells from extracellular fluid through increasing endogenous catechlolamine release. The serum potassium in 12 cases returned to normal quickly within 24 hours after ROSC. The difference between CPCR success rate in both groups were not significant satisti- cally (58.3% vs 50% P>0.05). It is suggested that hypokalemia after CPR is not important prognostic factor in patients with cardiac arrest.

关 键 词：心肺复苏 电解质紊乱 加强生命维护 

分 类 号：R605.974[医药卫生—急诊医学]