Dufel S E
Emerg Med Clin North Am. 1986 Feb;4(1):185-92.
Urinary electrolytes can be a useful tool in the Emergency Department. For those patients with volume depletion, acute oliguria and hyponatremia, the determination of urinary sodium levels can aid in diagnosing the etiology of the presenting condition. Urinary potassium levels can aid the clinician in determining the cause of the potassium loss, either renal or extrarenal. For those patients with metabolic alkalosis, determination of the urinary chloride levels will allow the physician to determine if the alkalosis is chloride responsive or chloride resistant. It must be kept in mind that the measurement of any urinary electrolyte is relatively valueless unless it is interpreted with other data and/or observation of the patient. It should be noted also that a solitary value may not be adequate for making a diagnosis, and serial urinary electrolyte value assessment may be necessary. In the critically ill patient, it may be prudent to obtain a urine sample before the administration of a diuretic, the administration of potassium, or large amounts of saline. This procedure will allow for a more accurate assessment of the patient's pretreatment status.
尿电解质在急诊科可能是一种有用的工具。对于那些存在容量不足、急性少尿和低钠血症的患者，测定尿钠水平有助于诊断当前病情的病因。尿钾水平可帮助临床医生确定钾丢失的原因，是肾性还是肾外性。对于那些患有代谢性碱中毒的患者，测定尿氯水平可使医生确定碱中毒是对氯有反应还是对氯无反应。必须牢记，除非与患者的其他数据和/或观察结果相结合进行解释，否则任何尿电解质的测量相对没有价值。还应注意，单一数值可能不足以做出诊断，可能需要连续评估尿电解质数值。对于危重症患者，在使用利尿剂、补钾或大量输注生理盐水之前采集尿液样本可能是谨慎的做法。这一操作将有助于更准确地评估患者的治疗前状态。
