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低钾性麻痹的起源与治疗(作者译)

[Origin and treatment of the hypokalemic paresis (author's transl)].

作者信息

Druschky K F, Wieck H H

出版信息

Fortschr Neurol Psychiatr Grenzgeb. 1976 Oct;44(10):570-8.

PMID:1049558
Abstract

The abuse of laxatives and a prolonged treatment with diuretics has to be brought into consideration as the most common cause for renal or intestinal loss of potassium. Besides characteristical alterations at the E.C.G. and besides intestinal disturbances there do occur again and again acute, life-threatening aspects of cases connected with tetraplegias and a respiratory failure. By means of 3 cases from our hospital and 27 casuistics in literature symptomatology and dynamic in the development of hypokaliemia is discussed. The mean of potassium in the serum of the 16 patients, those having quadriplegias, ran up to 1,7 mval/l (range 1,4-2,5). Paralysis develops peracutely in 4 of the cases within hours and in 12 of the cases within days. In the anamnesis symptoms of adynamia could be traced with nearly every patient. A functional psychosis (reversible physically founded psychosis) couldn't be detected in any of the cases. With the help of a administration of potassium one could achieve a total retrogression of the symptoms. Besides this a normalisation of the acide-base equilibrium is required because of a metabolic alkalosis, detectable in most of the cases.

摘要

滥用泻药以及长期使用利尿剂必须被视为导致肾脏或肠道钾流失的最常见原因。除了心电图的特征性改变以及肠道紊乱外,与四肢瘫痪和呼吸衰竭相关的病例还会反复出现急性、危及生命的情况。通过我院的3例病例以及文献中的27例病例分析,探讨了低钾血症的症状学和发展动态。16例四肢瘫痪患者的血清钾平均值高达1.7毫当量/升(范围为1.4 - 2.5)。4例患者在数小时内急性发生瘫痪,12例在数天内发生。在病史中,几乎每位患者都能追溯到乏力症状。在任何病例中均未检测到功能性精神病(可逆的躯体性精神病)。通过补钾,症状可完全消退。除此之外,由于大多数病例中可检测到代谢性碱中毒,还需要使酸碱平衡正常化。

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