低钾血症死因剖析

患者男性，46岁，因“全身乏力一周加重一天”入院。既往有类似发作病史，均诊断为“低钾血症"。入院时查体：T 36.3℃，P 66次/分，R 23次/分，Bp
125/85mmHg。神志清楚，背入病房，腱反射减弱，下肢软瘫。未查及其他阳性体征。于上午9:30分以“低钾血症”收入院，给予补钾、抗感染，对症支持治疗并行化验辅检以明确病因。入院后急查血象及血电解质提示：WBC 15.7×109/L, RBC 5.96×1012 /L, N 92.4%；K+ 2.7mmol/L , Na+ 150mmol/L, CL― 114.4mmol/L,
Ca++ 1.25mmol/L。9:50分床边心电图检查提示：窦性心律，部分T-U改变提示低血钾，心电轴中度左偏。晚7:00查肾功能提示：CO2Cp 20mmol/L(22-28),Cr
282.6umol/L(44-133),尿素 8.8mmol/L(1.8-8.3),血糖 9.7mmol/L(3.9-6.1), Ca++ 2.02mmol/L(2.1-2.6),尿酸 232.2umol/L(142-400),磷 0.96mmol/L(0.81-
1.55)。急查尿常规未提示异常。晚7:30复查血电解质示：K+ 1.96mmol/L , Na+ 146.2mmol/L, CL― 113mmol/L, Ca++ 1.10mmol/L。晚8:30左右出现心慌，呼吸费力，张口呼吸，全身虚汗，四肢冰冷，后口唇及耳缘紫绀，经抢救无效于晚9:30死亡，死亡诊断为：低钾血症并发心脏骤停。以下是患者住院期间的医嘱：
长 期 医 嘱
13/1 9:30Am 内科常规护理
13/1 9:30Am Ⅱ级护理
13/1 9:30Am 普食
13/1 9:30Am 留陪
13/1 11Am Tab Potassium Chloride 0.2 PO tid
13/1 11Am 0.9% NS 100ml
13/1 11Am 菌必治 2.0
13/1 11Am iv drop Bid
13/1 11Am 高病重
13/1 5pm 测Bp、P Q4h
13/1 8pm 计24h 尿量
13/1 9:30pm 死亡
临 时 医 嘱
13/1 9:30Am Blood-Rt st!
13/1 9:30Am Blood- K+、Na+、CL―、Ca++ st!
13/1 9:30Am 5% GS 500ml
13/1 9:30Am Vit C 3.0
13/1 9:30Am 10% Potassium Chloride 15ml
13/1 9:30Am iv drop 50gtt/min
13/1 9:30Am cefazolin AST (-)
13/1 9:30Am 5% GS 500ml
13/1 9:30Am 25% Magnesii Sulfas 20ml
13/1 9:30Am 10% Potassium Chloride 15ml
13/1 9:30Am 5% G.NS 500ml
13/1 9:30Am Vit B6 0.1
13/1 9:30Am 10% Potassium Chloride 15ml
13/1 9:30Am iv drop 40gtt/min
13/1 9:50Am 床边心电图
13/1 11Am 氯化钾缓释片 0.5×1盒
13/1 11Am Ringer’s 500ml
13/1 11Am Inosine 0.4
13/1 11Am 10% Potassium Chloride 10ml
13/1 11Am Saline 250ml
13/1 11Am 5% S-B 150ml
13/1 11Am iv drop 40gtt/min 最后用
13/1 4pm 5% G.NS 500ml
13/1 4pm 25% Magnesii Sulfas 10ml
13/1 4pm 10% Potassium Chloride 15ml
13/1 4pm Ringer’s 500ml
13/1 4pm 10% Potassium Chloride 10ml
13/1 4pm iv drop 50gtt/min
13/1 7pm 肾功能
13/1 7pm Urine-Rt st!
13/1 7:30pm Blood- K+、Na+、CL―、Ca++ st!
13/1 7:30pm Dexamethason 10mg iv st!
13/1 8pm 0.9% NS 500ml
13/1 8pm 10% Potassium Chloride 15ml
13/1 8pm 5% GS 500ml
13/1 8pm 10% Potassium Chloride 15ml
13/1 8pm 5% GS 500ml
13/1 8pm 10% Potassium Chloride 15ml
13/1 8pm Ringer’s 500ml
13/1 8pm 10% Potassium Chloride 10ml
13/1 8pm iv drop 50gtt/min 建立两条静脉通道
13/1 8:50pm 异丙肾上腺素针剂 1mg iv
13/1 9pm 肾上腺素针剂 1mg iv
13/1 9:10pm 肾上腺素针剂 2mg iv
13/1 9:11pm 肾上腺素针剂 4mg iv
13/1 9:14pm 10% Potassium Chloride 10ml slow iv st!
13/1 9:21pm 肾上腺素针剂 4mg iv
请问各位专家，患者致死原因为何？并请您对上诉诊治方案加以评估（上诉资料均属实），万分感谢并祝新年快乐、万事如意！