Brod J, Sterzel R B
Minerva Med. 1976 Nov 14;67(55):3607-20.
The disturbances of water and electrolyte metabolism in the body can be subdivided into three large groups: 1) disturbances of free water which are related to the whole body water and are always coupled with changes in the osmolality of the internal environment and also of the interior of the cells (hypertension due to loss of water, hypotension in water intoxication); 2) isotonic changes of the volume of the extracellular fluid-oedema or extracellular dehydration. The latter are always coupled with a hypovolaemia and with a danger to the circulation which may end in shock. There is also a cumulative loss of potassium as a result of the dehydration reaction; 3) disturbances of the intracellular water metabolism which are associated with disturbances of the potassium metabolism. These may have grave consequences for the function of striated and smooth muscles, for the function of the nerves and various enzyme systems. Since the disorders of the extracellular water balance are generally best known, the attention is principally drawn in this paper to the hypertonic dehydration and the status of the potassium metabolism. The symptomatology of both conditions is discussed, and also their diagnosis with the simplest laboratory effort not associated with great loss of time (which is essential if valuable time is not to be lost before the laboratory results can be obtained). The theoretical considerations are supplemented with clinical examples and explanations of the treatment.
1）自由水紊乱，与全身水有关，总是与内环境及细胞内渗透压的变化相关联（失水导致的高血压、水中毒导致的低血压）；2）细胞外液量的等渗性变化——水肿或细胞外脱水。后者总是伴有血容量减少以及循环危险，可能最终导致休克。脱水反应还会导致钾的累积性丢失；3）细胞内水代谢紊乱，与钾代谢紊乱相关。这些可能对横纹肌和平滑肌的功能、神经功能及各种酶系统产生严重后果。由于细胞外水平衡紊乱通常最为人熟知，本文主要关注高渗性脱水及钾代谢状况。讨论了这两种情况的症状学，以及用最简单的实验室检查进行诊断，且不耗费大量时间（如果要在获得实验室结果之前不浪费宝贵时间，这一点至关重要）。理论探讨辅以临床实例和治疗解释。
