Nikolić-Djurović M, Marisavljević D, Popović-Brkić V, Mićić J
Institute of Endocrinology, Diabetes and Metabolic Diseases, University Clinical Centre, Belgrade.
Srp Arh Celok Lek. 1990 Sep-Oct;118(9-10):407-10.
Grave hyperkalemic is a serious metabolic disorder. Its treatment fell into the fields of urgent medicine because of the risk of malignant cardiac arrhythmias that can be fatal for the patient. The article deals with the treatment of a 49-year-old female patient with decompensated liver cirrhosis and diabetes mellitus in whom grave hyperkalemia (9 mmol/1) with typical electrocardiographic changes was provoked by potassium saving diuretics combined with furosemide and the additional potassium substituted drugs, as well as development of diabetic ketoacidosis. Thanks to intensive medicinal treatment and constant follow-up of the patient rapid disappearance of hyperkalemia and ketoacidosis was observed. The success of medicinal therapy can be expected in cases of extreme hyperkalemia and relative hypokaliaemia. Intracellular hyperkaliaemia must be treated, without delay, with dialysis. Potassium saving diuretics and furosemide do not require additional potassium drugs, especially in risk patients in whom hyperkalemia may develop because of other existing diseases.
严重高钾血症是一种严重的代谢紊乱。由于恶性心律失常的风险可能对患者致命，其治疗属于急救医学领域。本文论述了一名49岁患有失代偿期肝硬化和糖尿病的女性患者的治疗情况，该患者因保钾利尿剂联合呋塞米及其他补钾药物引发了严重高钾血症（9 mmol/L）并伴有典型心电图改变，同时还出现了糖尿病酮症酸中毒。得益于强化药物治疗和对患者的持续随访，观察到高钾血症和酮症酸中毒迅速消失。在极端高钾血症和相对性低钾血症的情况下，药物治疗有望取得成功。细胞内高钾血症必须立即通过透析进行治疗。保钾利尿剂和呋塞米不需要额外的补钾药物，尤其是在因其他现有疾病可能发生高钾血症的高危患者中。
