Chhabra A, Patwari A K, Aneja S, Chandra J, Anand V K, Ahluwalia T P
Department of Pediatrics, Lady Hardinge Medical College, New Delhi.
Indian Pediatr. 1995 Apr;32(4):409-15.
Twenty-three children from 8-60 months (mean age 21.13 months) admitted with neuromuscular manifestations of diarrhea related hypokalemia were studied. Forty four per cent cases were suffering from diarrhea at the time of admission but in majority of cases (56%), the diarrheal episode had already terminated. Mild hypokalemia was seen in 17.4%, moderate in 43.5% and severe in 39.1%. Neck flop was the commonest (100%) neuromuscular manifestations followed by diminished bowel sounds (82.6%), truncal weakness (52.2%), weakness of limbs (52.2%), lethargy (43. 5%), abdominal distension (43.5%), respiratory involvement (4.3%) and phantom hernia (4.3%). Two cases (8.7%) had flaccid paralysis of both the lower limbs. Severe hypokalemia was more frequently observed in children below 24 months of age and those who had received i.v. fluids or salt sugar solution before reporting in the hospital. A significant correlation was noticed between severity of hypokalemia and frequency of stools (p < 0.05), degree of dehydration (p < 0.01), severity of nutrition (p < 0.01) and extent of neuromuscular involvement (p < 0.01). Our results highlights the importance of diarrhea related hypokalemia particularly in young malnourished children who are rehydrated with solutions inadequate in potassium. Early diagnosis and appropriate treatment can promptly reverse these manifestations within 48-72 hours.
对23名年龄在8 - 60个月（平均年龄21.13个月）因腹泻相关性低钾血症出现神经肌肉表现而入院的儿童进行了研究。44%的病例在入院时患有腹泻，但大多数病例（56%）腹泻发作已经结束。轻度低钾血症见于17.4%的病例，中度见于43.5%，重度见于39.1%。颈部松软是最常见的（100%）神经肌肉表现，其次是肠鸣音减弱（82.6%）、躯干无力（52.2%）、肢体无力（52.2%）、嗜睡（43.5%）、腹胀（43.5%）、呼吸受累（4.3%）和假疝（4.3%）。2例（8.7%）出现双下肢弛缓性麻痹。重度低钾血症在24个月以下的儿童以及在入院前接受过静脉输液或盐糖溶液的儿童中更常见。低钾血症的严重程度与大便次数（p < 0.05）、脱水程度（p < 0.01）、营养严重程度（p < 0.01）和神经肌肉受累程度（p < 0.01）之间存在显著相关性。我们的结果强调了腹泻相关性低钾血症的重要性，特别是在营养不良的幼儿中，这些幼儿用钾含量不足的溶液进行补液。早期诊断和适当治疗可在48 - 72小时内迅速逆转这些表现。
