重症肺炎并电解质紊乱的临床分析

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目的探讨重症肺炎并电解质紊乱的原因、治疗和转归。方法报告了汕头大学医学院第一附属医院于1999-2003年采用7170-A型全自动生化分析仪检测107例重症肺炎患者的电解质。血钠低于120mmol/L,予3%-5%氯化钠溶液治疗;血钾低于3.0mmol/L,每天补氯化钾6-8g;并对患者的临床表现及转归等进行统计分析。结果107例中低钠血症64例(59_8%),低钾血症45例(42.1%)。64例重症肺炎伴低钠血症者,治愈及好转31例(48.4%),43例未伴低钠者,治愈及好转32例(74.4%),P<0.01;64例低钠患者42例成功纠正低钠,其中治愈和好转27例(64.3%),而22例纠正低钠失败者,治愈和好转4例(18.2%),P<0.01。结论重症肺炎常并发电解质紊乱,以低钠血症最为常见,并明显影响预后;常规监测电解质,及时纠正紊乱能明显提高重症肺炎的抢救成功率。 Objective To investigate the causes, treatment and prognosis of severe pneumonia with electrolyte imbalance. Methods The first Affiliated Hospital of Shantou University Medical College in 1999-2003 reported using 7170-A automatic biochemical analyzer 107 patients with severe pneumonia electrolyte. Serum sodium less than 120mmol / L, to 3% -5% sodium chloride solution treatment; serum potassium less than 3.0mmol / L, potassium chloride daily supplement 6-8g; and the clinical manifestations and outcome of such statistics analysis. Results Among 107 cases, 64 cases (59_8%) had hyponatremia and 45 cases (42.1%) had hypokalemia. Of 64 patients with severe pneumonia with hyponatremia, 31 cases (48.4%) were cured and improved, 43 cases were not accompanied by hyponatremia, 32 cases were cured and improved (74.4%), P <0.01; Among them, 27 cases (64.3%) were cured and improved, while 22 cases were corrected for hyponatremia, 4 cases were cured and improved (18.2%), P <0.01. Conclusion Severe pneumonia often complicated with electrolyte imbalance, with hyponatremia is the most common, and significantly affect the prognosis; routine monitoring of electrolytes, and timely correction of disorders can significantly improve the success rate of severe pneumonia rescue.
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