低钠血症与肝性脑病的关系  

The relationship between hyponatremia and hepatic encephalopathy

作　　者：张光曙 周秀梅 张玲 李金峰 刘静 丁明权 甘天福 于建国 Zhang Guangshu,Zhou Xiumei,Zhang Ling,et al. The 88th Hospital of PLA,Taian 271000,China

机构地区：88医院,山东,泰安,271000

出　　处：《前卫医药杂志》2001年第4期249-251,共3页Qianwei Journal of Medicine & Pharmacy

摘　　要：目的利尿是肝硬变腹水的主要治疗措施,但并非病因治疗,需要研究.方法收集我院肝硬变腹水住院病人病历680份,逐份分析.结果入院前即因使用利尿剂,38.4%病人出现低血Na+,治疗后68.2%上升,平均下降8.4～9.4mmol/L,血Na+含量平均降至121.3～124.9mmol/L;临床显示肝昏迷者76.6%血Na+均在130mmol/L以内;而未使用利尿剂者,血Na+均在正常范围内,而且低血Na+与肝昏迷的出现有一定关系.结论利尿剂治疗中引起的低血Na+可导致脑水肿出现脑功能障碍,值得重视.三原则两辅助治疗措施可以避免这一缺点.Objective Although diuretics has been used as a main measure for treating liver cirrhosis with ascites,really it was only based on symptomatic principle,thereby study should be carried out again.Methods Data of cases of liver cirrhosis with ascites hospitalized in our institute were collected in 680 and studied one by one.Results Among the 680 cases 234(38.4%) had already hyponatremia,perhaps caused by diuretics before admission,and it increased to 68.2% after treatment with decrease of 8.4～9.4mmol/L and reduction of Na + to 121.3～124.9mmol/L on the average,and especially hyponatremia was just in accordance with the appearance of hepatic encephalopathy but the patients treated without diuretics were all in normal range.Conclusion Hyponatremia induced by diuretics might lead the patient to brain edema first and then encephalopathy.

关 键 词：肝硬变腹水 利尿剂 水电失衡 肝昏迷 三原则两辅助 并发症 

分 类 号：R575.206[医药卫生—消化系统;医药卫生—临床医学;医药卫生—内科学]