视神经脊髓炎合并抗利尿激素分泌不全综合征的观察与护理  

Observation and nursing for patients with neuromyelitis optica and syndrome of inappropriate antidiuretic hormone secretion

作　　者：庄红花[1] 范永祥[1] 吴林展 钟容[1] 单福兰 高聪[1] 龙友明[1] 

机构地区：[1]广州医科大学附属第二医院神经内科,510260

出　　处：《齐齐哈尔医学院学报》2016年第15期1973-1976,共4页Journal of Qiqihar Medical University

基　　金：国家自然科学基金资助(编号81441114)

摘　　要：目的总结视神经脊髓炎合并抗利尿激素分泌不全综合征（SIADH）的护理特点,指导临床护理,提高护理水平。方法回顾性的研究方法对符合入选标准的患者进行分析和比较。结果 7例视神经脊髓炎/谱系疾病患者纳入本研究。所有患者均经严密观察病情,监测水、电解质等各项指标。患者行免疫治疗和合理补液、饮食护理、基础护理和心理护理措施。7例患者中有1例患者（14.3%）出现SIADH反复发作。治疗前后的指标比较显示：治疗前最低平均血钠水平为（123.63±4.35）mmol/L,治疗后血钠水平（140.1±2.59）mmol/L。治疗前最低平均渗透压（248.62±7.79）mmol/L,治疗后平均渗透压力（281.75±6.78）mmol/L。治疗前后血钠水平、渗透压变化均有统计学意义（P〈0.0001）。患者平均恢复正常血钠与血渗透压的时间为7.17±1.57（5~9）天。6例患者经纠正血钠水平后,精神症状均恢复正常。结论视神经脊髓炎/谱系疾病患者合并SIADH的临床表现缺乏特异性。但患者的治疗与护理有别于其他原因引起SIADH,护理人员应认识这一特点。Objective To analyze the clinical nursing characteristic of syndrome of inappropriate antidiuretic hormone secretion（SIADH） merged neuromyelitis optica（NMO）,and explore the clinical guidance for it,so as to improve the nursing skills.Methods Clinical data of patients were analyzed retrospectively.Results Seven patients met the criteria of SIADH were included.All patients experienced observation（monitoring the liquid and electrolyte）,immune-therapy,reasonable liquid supplement,diet nursing,routine nursing and psychological nursing.One in seven patients suffering repeated outbreak of SIADH.Before the treatment,mean Na ＋ level in blood was 123.63 ± 4.35 mmol/L and osmotic pressure was 248.62 ± 7.79.At the end of therapy,mean Na ＋ level in blood was 140.1 ± 2.59 mmol/L and osmotic was 281.75 ± 6.78,the change was statistically significant（P〈0.0001）.The average recovery time of blood Na ＋ level and osmotic pressure was（7.17 ± 1.57 days）.After the resolve of hyponatremia,6 cases with mental symptom were recovered.Conclusions SIADH merged NMO/NMOSD had no specific features.However,its therapy and nursing differ from SIAHD induced by other reasons.

关 键 词：视神经脊髓炎 抗利尿激素分泌不全综合征 护理 

分 类 号：R744.52[医药卫生—神经病学与精神病学]