目的

评估分析温州医科大学附属第二医院2013年血钾危急值科室分布情况，为确定不同临床科室血钾危急值定值提供调整依据。

方法

采用回顾性资料调查研究。运用温州医学院附属第二医院信息技术中心自主研发的实验室管理软件统计2013年全院血钾检测项目总数检出和血钾危急值总数 (我院设定血钾危急值范围为低血钾≤3.0 mmol/L，高血钾≥6.0 mmol/L)及血钾危急值检出率，并评价分析检出血钾危急值患者在临床科室分布和临床处理率。

结果

2013年全院血钾危急值检出率为2.1%(4661/218918份)，以低血钾为主，占血钾危急值总数的79.02%(3683/4661份)，高血钾占20.98%（978/4661份)。血钾危急值发生前3位的病区为内科、肾内/血透中心、胃肠/肝胆外科，构成比分别为12.9%(465/3605份)、9.63%(347/3605份)、8.02%(289/3605份)。非新生儿病区中血钾危急值患者处理率为98.9%(989/1000份)，其中高血钾患者处理率为99.1% (329/332份)；低血钾患者2 h内处理率为98.8%(660/668份)；新生儿病区高血钾患儿处理率为18.5% (15/81份)，低血钾患者处理率为100.0%(33/33份)，新生儿病区血钾危急值患儿总处理率为42.1%(48/114份)。

结论

我院血钾危急值范围仅适用于各成人病区；而新生儿病区高血钾危急值临床处理率不高，新生儿科专家与大夫建议调高新生儿病区血钾危急值上限，以建立更科学合理的、可排除新生儿生理性黄疸期一过性高血钾的血钾危急值范围。

Objective

To analyze the distribution of the urgent value of serum potassium in the Second Hospital of Wenzhou Medical University in 2013, and to provide the adjustment basis for determining the value of potassium in different clinical departments.

Methods

Retrospective datas investigation.The data was collected by the laboratory management software developed by the center of information technology in our hospital. The total number of urgent value of serum potassium (the range of urgent value of serum potassium in our hospital was low K≤3.0 mmol/L and high K≥6.0 mmol/L), the total number of serum potassium in 2013, and the reporting rate of urgent value of serum potassium were statisticed.The clinical department distribution and the clinical treatment rate of serum potassium was evaluated.

Results

The reporting rate of urgent value of serum potassium was 2.1%(4661/218918) in the second hospital of Wenzhou Medical University in 2013. The urgent value of serum potassium distributed primarily within K≤3.0 mmol/L range, accounting for 79.02% (3683/4661); and the total number of the urgent value of serum potassium within K≥6.0 mmol/L range was 20.98%（978/4661). The ward with the total number of urgent value of serum potassium at first three were department of internal (respiratory, digestive,blood), kidney dialysis /centers of gastrointestinal, department of hepatobiliary surgery, The constituent ratios were 12.9% (465/3605), 9.63% (347/3605), and 8.02% (289/3605). The treatment rate of hyperkalemia in patients without neonatal ward was 99.1% (329/332); The treatment rate of hypokalemia in patient was 98.8% (660/668). The total treatment rate was 98.9% (989/1000). In neonatal ward, the treatment rate of hyperkalemia was 18.5% (15/81), the treatment rate of hypokalemia was 100% (33/33). In eonatal ward the total processing was 42.1% (48/114).

Conclusions

Existing potassium urgent value range is applicable to all major wards (except neonatal ward), The rate of clinical treatment for hyperkalemia is not appropriate in neonatal ward in the hospital. Paediatricians suggest the feasibility of increasing the upper limit of the urgent value in neonatal ward. It is essential to establish a more scientific and reasonable range of urgent value of serum potassium in neonatal ward, which can eliminate the physiological jaundice of newborn period when they are over the critical value range of hyperkalemia.