重型颅脑损伤并发低钠血症的临床诊治  

Clinical diagnosis and treatment of hyponatremia after severe head injury

作　　者：宋立坤[1] 李爱民[2] 刘希光[2] 李宁[2] 封硕[1] 

机构地区：[1]江苏徐州医学院 [2]江苏徐州医学院附属连云港医院神经外科,连云港222000

出　　处：《河南外科学杂志》2011年第4期16-18,共3页Henan Journal of Surgery

摘　　要：目的探讨重型颅脑损伤后并发低钠血症的病因、临床特点及诊治措施。方法回顾分析51例重型颅脑损伤(其中38例需要手术治疗)后并发低钠血症的临床资料,分析其原因,总结其临床特点及治疗方法和效果。结果重型颅脑损伤并发低钠的51例患者,低钠血症治愈47例,因脑损伤严重死亡2例,需长期高钠饮食以维持血钠正常1例,家属放弃治疗1例。结论重型颅脑损伤并发低钠血症以抗利尿激素分泌不当综合征和脑性耗盐综合征2种类型为主。2者发病机制不同,需要认真鉴别诊断,区别治疗。Objective To research pathogeny, the clinical characteristic, diagnosis and treatmnt of hyponatremia after severe head injury. Methods Reviewed 51 cases of hyponatremia after severe head injury and analyzed the pathogeny,summarized the clinical characteristic and treatment methods and the therapeutic effects. Results Among 51 cases of hyponatremia after severe head injury,47 healed, 1 case was dead due to severe brain injury, 1 case must be treated to maintain the natrium of blood in well - balanced by hyper - saline meat, and 1 patient＇ s families withdrawing treatment. Conclusion Hyponatremia after severe head injury he mainly composed by syndrome of inappropriate antidiuretic hormone secretion and cerebral salt wasting syndrome. TCSWS and SIADH require careful differential diagnosis and different approach to treat them, because there are different between their pathogenesis.

关 键 词：重型颅脑损伤 低钠血症 临床诊治 

分 类 号：R651.15[医药卫生—外科学]