目的 探讨腹部外科血钾水平监测的临床路径,以求证潜在低钾评估先行于院前的重要性.方法 采用随机数字表法分组,将118例行开腹手术的低钾患者分为观察组(60例)和对照组(58例),将血钾采血时点化,按院前一术前一术后的序贯监测作阶段性干预,对比分析两组的血钾时点化监测、术后内脏动力学指标.结果 两组入院时平均血钾水平、术后首次进水、排气时间比较均P＜0.01,差异有显著意义；两组术后24 h、48 h平均血钾水平、术后首次排便、排尿、离床活动时间比较,P＜0.05,差异有显著意义.结论 优化血钾监测路径,不仅为病区节约了患者手术等待期的有限床位资源,还可为行开腹术的低钾患者早预防、早发现、早纠正、早手术、早康复创造条件,为院前、院后联合干预的理想方式.%Objective To investigate the clinical pathways monitoring the serum potassium levels in hypokalemia patients undergoing open abdominal surgery and verify the importance of potential hypokalemia assess pre hospital.Method A total of 118 hypokalemia patients undergoing open abdominal surgery randomized into observation group (60 cases) and control group (58 cases).In control group,bloods were sampled at scheduled time points (preadmission,admission,postoperative 24 h and postoperative 48 h),and the interventions were involved in the preadmission and pre and postoperative periods.In the observation group,blood sampling was delayed after admission,and the interventions were only performed during the pre and postoperative periods.In terms of blood potassium and gastrointestinal motility were compared.Result The average serum potassium level when admission,the first water drinking time and the first bowel-sound differed statistically between the two groups (P＜0.01).When postoperative 24 h and 48h,the average serum potassium level,the first defection,urination,bed-off time differed statistically between the two groups (P＜0.05).Conclusion Optimization of potassium monitoring pathways,not only saves the limited beds in the ward for patients,but also allows for the early prevention,detection,correction,surgery,and recovery of patients receiving open abdominal surgeries,and also could be an ideal intervention united preadmission and admission.
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