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目的 探讨食管贲门癌术后早期血钾的变化及早期补钾的临床意义。方法 对 40例食管贲门癌病人术前及术后第 1、2、3天血钾进行检测 ,并早期静脉补钾 ,分析围手术期血钾变化的趋势 ,研究术后早期补钾的可行性、必要性及安全性。结果 食管贲门癌病人血钾术前 (4.0 8± 0 .32 )mmol L ,术后第 1天为 (3 .86± 0 .31)mmol L(P <0 .0 1)、第 2天 (4.0 2± 0 .2 7)mmol L(P >0 .0 5 )、第 3天 (4.0 6±0 .2 2 )mmol L(P >0 .0 5 ) ,无 1例出现高钾血症。结论 食管贲门癌术后血钾并非升高 ,而是呈减低趋势 ,只要肾功能正常 ,早期补钾是必要的、安全的及可行的。
Objective To investigate the changes of serum potassium levels and the clinical significance of early potassium supplementation after esophageal and cardiac cancer surgery. Methods 40 cases of esophageal and cardiac cancer patients before and after surgery on the 1st, 2nd and 3rd day blood potassium were detected, and the early intravenous potassium, analysis of the trend of changes in serum potassium during the perioperative period, to study the feasibility of early postoperative potassium , necessity and safety. Results Preoperative plasma potassium levels in patients with esophageal and cardiac cancer (4.08±0.32 mmol L) were (3.86±0.31) mmol L (P < 0.01) on the first postoperative day, and on the 2nd day ( 4.0 2± 0 .27 7) mmol L (P 0. 05), 3rd day (4.0 6±0.22) mmol L (P 0. 05), no case of hyperkalemia . Conclusions Postoperative blood potassium does not increase in esophageal and cardiac cancer patients, but it shows a decreasing trend. As long as the renal function is normal, early supplementation of potassium is necessary, safe, and feasible.