重型颅脑损伤术后脑性盐耗综合征补钠量计算公式的临床研究  

A new formula for patients with cerebral salt wasting syndrome after severe head injury to calculate the supplement amount of sodium

作　　者：王国兴[1] 周正华[1] 肖薇[1] 黄富[1] 肖华[1] 

机构地区：[1]广州市花都区人民医院神经外科,510800

出　　处：《中华神经医学杂志》2014年第3期235-238,共4页Chinese Journal of Neuromedicine

基　　金：广州市医药卫生科技项目（201102A212027）

摘　　要：目的探讨重型颅脑损伤后脑性盐耗综合征（Csws）患者补钠量的计算方法。方法广州市花都区人民医院神经外科自2008年3月至2013年2月共收治56名重型颅脑损伤术后CSWS患者，按随机数字表法分为传统补钠公式治疗组（28例）和新补钠公式治疗组（28例），分别依据经典补钠公式和新补钠公式计算补钠量后补钠，治疗后连续7天监测血钠水平、颅内压，比较2组患者血钠及颅内压的变化情况。对患者随访6个月后比较2组患者低钠血症的纠正时间和预后。结果与传统补钠公式治疗组相同时间点比较，治疗后第3、4、5、6、7天新补钠公式治疗组患者血钠水平较高，第4、5、6、7天颅内压水平较低，差异有统计学意义（P〈0．05）；与传统补钠公式治疗组比较，新补钠公式治疗组患者低钠血症纠正时间较短，预后良好率（57％＇US25％）较高，差异有统计学意义（P〈0．05）。结论应用新补钠公式对重型颅脑损伤术后CSWS患者进行补钠治疗是安全有效的．可以改善患者的预后。Objective To study the method of calculating the supplement amount of sodium for the severe head injury patients suffered cerebral salt wasting syndrome （CSWS）. Methods Fifty-six patients with CSWS after severe head injury, admitted to our hospital from March 2008 to February 2013, were chosen and randomly divided into two groups： group A （n=28）, using the traditional formula to calculate the amount of sodium supplement, and group B （n=28）, using our new formula to calculate the amount of sodium supplement. The sodium levels and intracranial pressure after intravenous administration were monitored and compared for 7 days. All the patients were followed up for 6 months, and their prognosis by Glasgow outcome scale （GOS） scores and the corrected time of hyponatremia were compared between the two groups. Results The hyponatremia of the two groups were corrected after treatment. The serum sodium level of group B was higher than that of group A 3, 4, 5, 6 and 7 d after sodium supplement （/＇〈0.05）; the intracranial pressure of group B was lower than that of group A 4, 5, 6 and 7 d after sodium supplement （P〈0.05）. Group B needed shorten time in correcting the hyponatremia and had higher good prognosis rate as compared with group A（P〈0.05）. Conclusion The new sodium supplement formula in treating the severe head injury patients suffered CSCW is safe and effected, which can improve the prognosis of these patients.

关 键 词：脑性盐耗综合征 低钠血症 重型颅脑损伤 

分 类 号：R651.15[医药卫生—外科学]