重型颅脑损伤并低钠血症164例临床分析  

Clinical analysis of 164 cases of hyponatremia after severe craniocerebral injury

作　　者：陈焕清[1] 缪瑞明[1] 邱嘉民[1] 肖秀红[1] 赵凤如[1] 张向葵[1] 梁佩兰[1] 蔡望青[1] 邓若飞[1] 何志捷[1] 

机构地区：[1]中山大学附属第二医院,广州510120

出　　处：《医师进修杂志（外科版）》2005年第12期6-8,共3页

摘　　要：目的探讨重型颅脑损伤(SCI)后低钠血症的病因、发病机制及其防治。方法总结近年来收治的重型颅脑外伤后低钠血症患者164例,分析影响低钠血症发生发展的各种因素,从而探讨其临床特点、发病机制及防治对策。结果在SCI患者中低钠血症的发生率为31.5%,平均发生在伤后(6.3±0.7)d,持续时间平均(4.9±0.5)d,平均血清钠浓度为(122.1±9.7)mmol/L。抗利尿激素不适当分泌综合征(SIADH)、脑盐耗综合征(SCWS)和其他类型的低钠血症在恢复时间及治愈率方面差异均无统计学意义,而预后与病情轻重有密切关系,病情越重(GCS评分越低),低钠血症发生率越高,低钠血症越严重,病死率越高。结论对SCI患者应密切监测血钠浓度,早期发现并鉴别低钠血症的类型,及时而有针对性地治疗低钠血症对改善预后具有重要意义。Objective To approach the causes, pathogenesis, preventions and treatments of hyponatremia after severe craniocerebral injury （SCI）. Methods Various kinds of influenced agents of hyponatremia were analyzed on 164 patients after SCI. The causes, pathogenesis, preventions and treatments were intensively studied. Results The incidence rate of the SCI with hyponatremia was 31.5%, they were occuffed in average （6.3 ± 0.7） days after injury. And the lasting- time was in average （4.9 ± 0.5） days,the average concentration of natrium in blood serum was （122.1 ± 9.7） mmol/L. There were no significant difference among the syndrome of inappropriate secretion of antidiuetic hormone （SIADH）, cerebra salt wasting syndrome （CSWS） and other types of hyponatremia in recovery time and cure rate. The prognosis had intimate relation with the patient＇s condition. The more severe the patient＇s condition was,the higher the incidence of hyponatremia occurred. The lower the natrium in blood serum was,the higher the fatality rate was. Conclusion The blood natrium concentration on SCI must be intimately monitored. It is very important to find and treat hyponatremia early for improving the prognosis.

关 键 词：重型颅脑损伤 低钠血症 发生机制 预防 治疗 

分 类 号：R651.15[医药卫生—外科学] R591.1[医药卫生—临床医学]