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目的分析慢性心力衰竭(CHF)合并严重低血钾致心脏骤停的经验教训。方法选择612例CHF住院患者,合并有低血钾者86例,其中5例发生恶性室性心律失常而致心脏骤停,其中风心病2例,扩张型心肌病2例,冠心病1例;血钾在2.0~2.98mmol/L。心脏骤停前均有频发室性早搏、室速、尖端扭转型室速等心律失常。均给予静脉、口服补钾及抗心律失常处理。结果 5例均抢救成功,血钾2~3d内恢复正常。结论长期、大剂量利尿剂的使用是导致CHF合并低血钾的主要原因,及时合理补钾、合理使用血管紧张素转换酶抑制剂及醛固酮受体拮抗剂可减少低血钾的发生,发生心律失常时及时静脉及口服补钾、抗心律失常处理可防止恶性心律失常。
Objective To analyze the experiences and lessons of cardiac arrest in patients with chronic heart failure (CHF) complicated by severe hypokalemia. Methods Sixty - six CHF hospitalized patients were selected, including 86 cases with hypokalemia and 5 cases with cardiac arrest caused by malignant ventricular arrhythmia. Among them, 2 cases were rheumatic heart disease, 2 cases were dilated cardiomyopathy and 1 case was coronary heart disease. Potassium in the 2.0 ~ 2.98mmol / L. Before cardiac arrest, both premature ventricular contractions, ventricular tachycardia, torsades de pointes reverse arrhythmia. All given intravenous, oral potassium and anti-arrhythmic treatment. Results 5 cases were successfully rescued, serum potassium within 2 ~ 3d returned to normal. Conclusion Long-term and high-dose diuretic use is the main reason leading to CHF combined with hypokalemia. Timely and reasonable use of potassium, proper use of angiotensin converting enzyme inhibitors and aldosterone receptor antagonists can reduce the incidence of hypokalemia and lead to heart rhythm Disorders, timely intravenous and oral potassium, anti-arrhythmic treatment to prevent malignant arrhythmia.