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我院有两名作规律性、维持性透析的尿毒症患者在透析期间几次出现阿斯综合征,究其原因主要是高钾引起的高度危险性心律失常。二例相继或先后出现过结性逸搏心律(20～30次/min)、室性选搏心律、短阵性室速、室颤、多源性室性早搏等心律失常。一例室性逸搏心律,心率20～30次/min时多次发生阿斯综合征,经常规治疗后,并用异丙肾上腺素维持心率在>40次/min,收缩压>12kPa后作了紧急透析,透析5h血钾才由5.8mmol/L降低到4.8mmol/L,心律才由室性逸搏心律转变成窦性心律伴多源性定性早搏。另一例在1小时内3次出现室颤,后经电除颤转为结性逸搏心律,经血透半小时血钾由8.2mmol/L降低到5.8mmol/L,结性逸搏心律(用异丙肾上腺素维持心率在40～80次/min)转变成窦性心律,20分钟后再转成房颤(患者原有房颤律).两患者现仍在作规律性透析已一年有余。
In our hospital there are two regular, maintenance dialysis uremia patients with Aspergillus syndrome several times during dialysis, mainly due to high potassium caused by high risk arrhythmia. Two cases have been successively or successively occurred knot Yaxi rhythm (20 ~ 30 times / min), ventricular beat heart rate, short-term ventricular tachycardia, ventricular fibrillation, ventricular arrhythmias such as premature ventricular contractions. One case of ventricular escape rhythm, heart rate 20 to 30 times / min, Asi syndrome occurred many times, after conventional treatment, and isoproterenol to maintain heart rate> 40 beats / min, systolic blood pressure> 12kPa after an emergency Dialysis, dialysis 5h serum potassium decreased from 5.8mmol / L to 4.8mmol / L, ventricular arrhythmias by ventricular transition to sinus rhythm with multiple qualitative qualitative premature beats. Another case of ventricular fibrillation occurred within three hours in 1 hour, after electrical defibrillation switch to rhythm of escaping, blood half-hour serum potassium decreased from 8.2mmol / L to 5.8mmol / L, Isoproterenol to maintain heart rate in the 40 to 80 beats / min) into sinus rhythm, 20 minutes before turning into atrial fibrillation (patients with atrial fibrillation.) The two patients are still regular dialysis for more than a year .