高血压性幕上脑出血术后并发中枢性低钠血症患者头颅CT表现的临床研究  

Clinical study of the cranial CT image of central hyponatremia postoperative patients with hypertensive supratentorial intracerebral hemorrhage

作　　者：王国兴[1] 黄富[1] 肖华[1] 

机构地区：[1]广东省广州市花都区人民医院神经外科,510800

出　　处：《中国现代医药杂志》2014年第4期47-50,共4页Modern Medicine Journal of China

摘　　要：目的探讨高血压性幕上脑出血术后并发中枢性低钠血症患者的头颅CT表现,以期通过头颅CT检查早期发现可能发生中枢性低钠血症的患者。方法回顾性分析我科276例高血压性幕上脑出血手术患者的临床资料,测量头颅CT中血肿边缘与丘脑中心的距离及丘脑手术前后摆动的距离,并通过统计学方法分析二者与中枢性低钠的关系。结果中枢性低钠血症患者血肿边缘到丘脑中心距离较非低钠血症患者小,而且术前、术后丘脑摆动距离较大,差异有统计学意义(P<0.05);血肿边缘到丘脑中心距离<10mm且术前、术后丘脑摆动距离≥10mm者发生中枢性低钠血症的比例较高(P<0.05)。结论高血压性幕上脑出血患者,血肿边缘到丘脑中心距离<10mm且术前、术后丘脑摆动距离≥10mm可能发生中枢性低钠血症,临床诊治过程中要注意及早采取相应预防措施,避免重度低钠血症的发生。Objective To explore the features of the cranial CT image of central hyponatremia postoperative patients with hypertensive supratentorial intracerebral hemorrhage,in order to discover the central hyponatremia patients earlier by the CT image. Methods Retrospectively analyzed the clinical data of 276 cases with hypertensive supratentorial intracerebral hemorrhage treated in our department. Measured the distance from hematoma edge to the hypothalamic centers and the swing distance of thalamus preoperative and postoperative,and analyzed the relationship between these two indexes and the central hyponatremia by statistical methods. Results The distance from hematoma edge to the hypothalamic center was smaller in the central hyponatremia patients than the non-hyponatremia patients,and the swing distance of thalamus preoperative and postoperative was farther,the difference was statistically significant（P〈0.05）. Patients were more prone to central hyponatremia with a distance from hematoma edge to the hypothalamic center less than 10mm and a swing distance of thalamus preoperative and postoperative more than 10mm（P〈0.05）. Conclusion Hypertensive supratentorial intracerebral hemorrhage patient who has a distance from hematoma edge to the hypothalamic center less than 10mm and a swing distance of thalamus preoperative and postoperative more than 10mm on the CT image, may suffer from central hyponatremia. During the process of clinical diagnosis and treatment early appropriate measure should be taken to prevent the occurrence of severe hyponatremia.

关 键 词：高血压脑出血 低钠血症 抗利尿激素分泌失调综合征 脑性盐耗综合征 

分 类 号：R651.1[医药卫生—外科学]