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目的探讨汶川地震挤压综合征伤员电解质紊乱的特点。方法对149例地震挤压综合征伤员的临床特点,尤其是电解质紊乱的特点进行分析。结果与非挤压综合征伤员比较,149例(8.2%)挤压综合征伤员有更严重的肾功能损害,血钾及血磷水平更高,血钙水平更低(P<0.05);同时表现出血清天冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)和肌酸激酶(CK)水平显著升高(P<0.05);电解质紊乱表现多种多样,包括高钾血症、低钾血症、低钠血症、低钙血症、高磷血症、低磷血症以及代谢性酸中毒,尤其是高钾血症,不但严重而且顽固,需要尽早积极治疗。结论地震后挤压综合征伤员表现出严重而且复杂的电解质紊乱,高钾血症是最严重的表现,需要密切监测和积极治疗。
Objective To investigate the characteristics of electrolyte imbalance in the crush syndrome in Wenchuan earthquake. Methods The clinical features of 149 cases of earthquake crush syndrome, especially the characteristics of electrolyte imbalance, were analyzed. Results Compared with the non-crush syndrome patients, 149 patients (8.2%) had more severe renal dysfunction, higher potassium and phosphorus levels, and lower serum calcium levels (P <0.05) Serum aspartate aminotransferase (AST), lactate dehydrogenase (LDH) and creatine kinase (CK) levels were significantly increased (P <0.05); electrolyte imbalances varied, including hyperkalemia , Hypokalemia, hyponatremia, hypocalcemia, hyperphosphatemia, hypophosphatemia and metabolic acidosis, especially hyperkalemia, not only serious and stubborn, need active treatment as soon as possible. Conclusions After the earthquake, the crush syndrome showed severe and complicated electrolyte imbalance. Hyperkalemia is the most serious manifestation and needs close monitoring and aggressive treatment.