临床误诊误治
臨床誤診誤治
림상오진오치
CLINICAL MISDIAGNOSIS & MISTHERAPY
2014年
10期
71-74
,共4页
佟威威%佟广辉%刘勇%卢丽萍%秦晓松
佟威威%佟廣輝%劉勇%盧麗萍%秦曉鬆
동위위%동엄휘%류용%로려평%진효송
水电解质失调%高钾血症%低钾血症%实验室人员
水電解質失調%高鉀血癥%低鉀血癥%實驗室人員
수전해질실조%고갑혈증%저갑혈증%실험실인원
Water-electrolyte imbalance%Hyperkalemia%Hypokalemia%Laboratory personnel
目的：探讨建立血清钾危急值报告制度的临床意义。方法回顾分析我院检验科2012年1-6月血清钾检测资料,以3.0 mmol/L为低血钾危急值界限值,6.0 mmol/L为高血钾危急值界限值,对报告的血清钾危急值患者进行临床追踪随访,记录患者分布情况,以及住院患者血清钾浓度分布情况、不同程度高钾血症及低钾血症患者的病死率、临床医生采取干预措施的时间。结果114871例次检测中共有2240例次(1.95%)血清钾检测达危急值,以住院患者为主。其中血清钾低危急值患者617例,高危急值患者201例,共死亡120例,病死率10.51%,低、高钾血症患者中分别以血清钾<2.50 mmol/L和>6.50 mmol/L者病死率最高；且低钾或高钾程度越严重的患者临床医生给予有效干预措施的时间越短。结论建立血清钾危急值报告制度对危险性电解质紊乱的临床救治、改善患者预后有重要意义。
目的：探討建立血清鉀危急值報告製度的臨床意義。方法迴顧分析我院檢驗科2012年1-6月血清鉀檢測資料,以3.0 mmol/L為低血鉀危急值界限值,6.0 mmol/L為高血鉀危急值界限值,對報告的血清鉀危急值患者進行臨床追蹤隨訪,記錄患者分佈情況,以及住院患者血清鉀濃度分佈情況、不同程度高鉀血癥及低鉀血癥患者的病死率、臨床醫生採取榦預措施的時間。結果114871例次檢測中共有2240例次(1.95%)血清鉀檢測達危急值,以住院患者為主。其中血清鉀低危急值患者617例,高危急值患者201例,共死亡120例,病死率10.51%,低、高鉀血癥患者中分彆以血清鉀<2.50 mmol/L和>6.50 mmol/L者病死率最高；且低鉀或高鉀程度越嚴重的患者臨床醫生給予有效榦預措施的時間越短。結論建立血清鉀危急值報告製度對危險性電解質紊亂的臨床救治、改善患者預後有重要意義。
목적：탐토건립혈청갑위급치보고제도적림상의의。방법회고분석아원검험과2012년1-6월혈청갑검측자료,이3.0 mmol/L위저혈갑위급치계한치,6.0 mmol/L위고혈갑위급치계한치,대보고적혈청갑위급치환자진행림상추종수방,기록환자분포정황,이급주원환자혈청갑농도분포정황、불동정도고갑혈증급저갑혈증환자적병사솔、림상의생채취간예조시적시간。결과114871례차검측중공유2240례차(1.95%)혈청갑검측체위급치,이주원환자위주。기중혈청갑저위급치환자617례,고위급치환자201례,공사망120례,병사솔10.51%,저、고갑혈증환자중분별이혈청갑<2.50 mmol/L화>6.50 mmol/L자병사솔최고；차저갑혹고갑정도월엄중적환자림상의생급여유효간예조시적시간월단。결론건립혈청갑위급치보고제도대위험성전해질문란적림상구치、개선환자예후유중요의의。
Objective To investigate the clinical significance of establishing the reporting system of critical value of serum kalium. Methods Serum kalium results from our laboratory between January and June 2012 were reviewed retrospec-tively by using criteria of≤3. 0 mmol/L as low critical value and≥6. 0 mmol/L as high critical value. The hospitalized pa-tients with reported critical value of serum kalium were all followed up for clinic, and their department distribution, distributed situation of serum kalium concentration, mortality rate of varying degree of hyperkalemia or hypokalemia and the time of start-ing treatment were all recorded. Results A total of 2240 in 114 847 (1. 95%) results were at critical value, which were mainly from inpatients. There were 617 patients with low critical value of serum kalium and 201 patients with high critical val-ue of serum kalium. A total of 120 patients died (10. 51%), and the mortality rate was high in patients with serum kalium lower than 2. 50 mmol/L or higher than 6. 50 mmol/L. The results showed that the more serious hypokalemia or hyperkalemia was, the shorter the time for clinicians responding to the critical results was. Conclusion Establishing a reporting system of critical value of serum kalium in laboratory has important significance to clinical treatment for serious electrolyte disorder and prognosis improvement.
