急性颈髓损伤继发低钠血症及循环系统变化的临床研究  

Clinical Study of Secondary Hyponatremia and Abnormalities of the Circulatory System in Patients with Acute Cervical Spinal Cord Injury

作　　者：吴朝明[1] 赵向彤[1] 潘优津[1] 郑超[1] 吴笑英[1] 孙来芳[1] 

机构地区：[1]温州医学院附属二院,温州325000

出　　处：《临床急诊杂志》2006年第1期8-9,共2页Journal of Clinical Emergency

摘　　要：目的研究急性颈髓损伤(CSCI)继发低钠血症与急性 CSCI 后出现的循环系统异常情况两者之间的关系,并探讨急性 CSCI 继发低钠血症的发生机制。方法回顾性分析126例急性 CSCI 患者的临床资料,比较低钠血症组与正常血钠组血压(BP)、心率(HR)变化,及轻、重度低钠血症患者的 BP、HR、中心静脉压(CVP)变化情况。结果低钠血症组的 BP、HR 均低于正常血钠组,差异有显著意义(P<0.01)。严重低钠血症组的 BP、HR、CVP 均低于轻度低钠血症组,有显著性差异(P<0.05)。结论急性 CSCI 继发低钠血症与急性 CSCI 时抑制了体内的交感神经系统相关,持续监测急性 CSCI 患者的 BP、HR、CVP 等循环系统指标可以预测 CSCI 后是否会发生低钠血症及其严重程度,对于急性 CSCI 患者的病情判断或预后估计有一定的临床意义。Objective To study the relationship between hyponatremia and changes within the circulatory system in patients with acute cervical spinal cord injury（CSCI） and to explore the pathogenesis of secondary hyponatremia. Methods 126 patients with CSCI were analysed for blood pressure（BP） and heart rate（HR）. The separated into normal natremic group（ n=52） and hyponatremic group （ n = 74）. BP and HR and eontral venous pressure（CVP） were then compared between the mild hyponatremic and the severe hyponatremic group. Results BP and H R for the hyponatremie group was significantly lower than the normal natremic group（ P 〈 0. 01 ）. The BP, HR, CVP for the severe hyponatremic group was significautly,lower than for the mild hyponatremic group（ P 〈 0. 05 ）. Conclusion Secondory hyponatremia may have an association with the sympathetic nervous system dysfunction in the patients with acute CSCI. Continuous monitoring of BP, HR, CVP will aid in the diagnosis and degree of secondary hyponatremia in the patients with acute CSCI and will provide an accurate prognosis.

关 键 词：急性颈髓损伤 低钠血症 循环系统 

分 类 号：R653[医药卫生—外科学]