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患者,男,34岁。四肢渐进性软瘫入院.查:神清合作,四肢肌力0～1级,腱反射消失,未引出病理征,心电图示低血钾,密性心律不齐伴I°房室传导阻滞(AVB),血清钾3.1mmol/L.诊断低钾性麻痹。经24h静脉补钾2g,口服3g,病情继续加重,复查血钾降至2.8mmol/L,考虑血液稀释效应和补钾的量和速度不够。复查心电图(见附图)示Ⅱ°Ⅰ型AVB,呈:1、3:1或5:1脱落现象,avL可见P—R间期由20s逐渐延长到0.58s,avF出现房性逸搏.经继续后病情好转、心电图恢复正常。
Patient, male, 34 years old. Limbs progressive soft paralysis hospitalized.Check: Shenqing cooperation, limb muscle strength 0 ~ 1, tendon reflex disappeared, did not lead to pathological sign, ECG hypokalemia, dense arrhythmia with I ° atrioventricular block ( AVB), serum potassium 3.1mmol / L. Diagnosis of hypokalemic paralysis. After 24h intravenous infusion of potassium 2g, oral 3g, the condition continued to increase, review the serum potassium dropped to 2.8mmol / L, consider the effect of hemodilution and the amount and rate of potassium is not enough. ECG review (see photo) showed Ⅱ ° Ⅰ type AVB, was: 1: 3: 1 or 5: 1 shedding phenomenon, avL visible P-R interval gradually extended from 20s to 0.58s, avF atrial escape. After the continuation of the condition improved, electrocardiogram returned to normal.