颅脑肿瘤手术后低钠血症87例临床分析  

作　　者：曹勇[1] 郑慧军[1] 苑亚东[2] 范鲁鼎[1] 张新昌[1] 

机构地区：[1]河南省中医院神经外科,河南郑州450000 [2]武警河南总队医院神经外科,河南郑州450000

出　　处：《中外医疗》2015年第3期61-62,共2页China & Foreign Medical Treatment

摘　　要：目的：探讨颅脑肿瘤手术后低钠血症的发病机制、临床表现和治疗方法。方法回顾性分析该院2009年2月—2014年2月收治的87例颅脑肿瘤术后低钠血症患者的临床资料,对患者的治疗方法进行分析，记录患者的尿钠、尿渗透压、血浆渗透压等指标。结果87例低钠血症患者中，轻中度低钠血症患者56例，重度低钠血症患者31例，轻中度低钠血症患者在治疗8~10 d后血钠和血容量恢复至正常，重度低钠血症患者在经过1~2个月的治疗后血钠水平恢复至正常，1例患者因血钠纠正过快而死亡。结论对颅脑肿瘤术后低血钠症的治疗要结合低钠血症的发生可能机制，明确低钠血症的诊断，进行补盐治疗，去除原发诱因，综合脑性盐耗综合征（CSWS）和抗利尿激素分泌异常综合征（SIADH）的治疗手段进行治疗，能够起到较好的治疗效果，有利于患者的预后。Objective to explore the pathogenesis of hyponatremia after craniocerebral tumor surgery, clinical manifestations and treatment methods. Methods a retrospective analysis of our hospital in February 2009 to February 2014 were analyzed in 87 cases of cerebral tumor postoperative hyponatremia in patients with clinical data, to analyze the treatment of patients, record the patient＇s urine sodium and urine osmotic pressure, plasma osmotic pressure and other indicators. Results of 87 patients with hyponatremia, 56 patients with mild-to-moderate hyponatremia, 31 patients with severe hyponatremia, mild-to-moderate hyponatremia patients in the treatment of 8-10 days after the blood sodium and blood volume back to normal, in patients with severe hyponatremia after 1 to 2 months after treatment serum sodium levels back to normal, 1 patients died of blood sodium correct too quickly. Conclusion the treatment of cerebral tumor postoperative low sodium blood sickness should combine the occurrence of hyponatremia possible mechanism, clear the diagnosis of hyponatremia, salt treatment, removal of the primary cause, comprehensive cerebral salt wasting syndrome （CSWS） and abnormal secretion of anti diuretic hormone （SIADH） treatments （SIADH） treatment, can play a good treat-ment effect, is helpful to the prognosis of patients.

关 键 词：颅脑肿瘤手术 低钠血症 临床分析 

分 类 号：R65[医药卫生—外科学]