中枢性低钠血症在颅内感染诊治中的临床价值  

Value of central hyponatremia in diagnosis and treatment of intracranial infection

作　　者：樊琪[1] 王超[1] 崔玲伟[1] 李腾宇[1] 马定军 朱蔚东[1] Fan Qi;Wang Chao;Cui Lingwei;Li Tengyu;Ma Dingjun;Zhu Weidong(Department of Neurosurgery,Dongzhimen Hospital Eastern Affiliated to Beijing University of Chinese Medicine,Beijing 100020,China)

机构地区：[1]北京中医药大学东直门医院东区神经外科,100020

出　　处：《中华临床医师杂志（电子版）》2017年第18期2234-2236,共3页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的分析颅内感染合并中枢性低钠血症的临床特征,探讨中枢性低钠血症在颅内感染诊治中的临床价值。方法收集北京中医药大学东直门医院东区神经外科2013年1月至2017年1月收治的颅脑损伤手术治疗后合并低钠血症患者72例,根据是否发生颅内感染分为颅内感染组(40例)和非颅内感染组(32例),根据血清钠值将颅内感染组分为轻度、中度、重度低钠血症3组,采用t检验比较颅内感染组和非颅内感染组血清钠水平的差异。颅内感染的3组间脑脊液白细胞计数及葡萄糖浓度采用单因素方差分析进行比较,采用LSD-t检验进行3组间脑脊液白细胞计数的两两比较。结果颅内感染组血清钠水平显著低于非颅内感染组(t=2.66,P=0.0103),颅内感染组轻度、中度、重度低钠血症患者间脑脊液白细胞数、脑脊液葡萄糖浓度比较,差异具有统计学意义(F=47.47,P=4.63E-11;F=4.18,P=0.023),脑脊液白细胞计数采用LSD-t检验进行组间的两两比较,各组间差异均有统计学意义(P<0.05)。结论颅脑损伤术后合并颅内感染的患者更易出现低钠血症,血清钠水平越低颅内感染的严重程度越严重。Objective To investigate the clinical significance of central hyponatremia in the diagnosis and treatment of intracranial infection.Methods Seventy-two postoperative patients with craniocerebral injury complicated with central hyponatremia were collected at Department of Neurosurgery,Dongzhimen Hospital Eastern Affiliated to Beijing University of Chinese Medicine and divided into an intracranial infection group(40 cases)and a non-intracranial infection group(32 cases).Based on the level of serum sodium,the intracranial infection group was further divided into three subgroups(mild,moderate,and severe).Comparisons of serum sodium were made between the two groups by the t-test,and white blood cell(WBC)count and glucose in cerebrospinal fluid(CSF)were compared among different subgroups in the intracranial infection group by one-way analysis of variance.Results There was a statistical difference in serum sodium between the two groups(t=2.66,P=0.0103).There was also a statistical difference in WBC count and glucose in CSF glucose among different subgroups in the intracranial infection group(F=47.47,P=4.63E-11;F=4.18,P=0.023).Conclusion Intracranial infection severity is inversely related to central hyponatremia;the more severe intracranial infection,the lower serum sodium.

关 键 词：颅脑损伤 颅内感染 低钠血症 脑脊液 

分 类 号：R742.9[医药卫生—神经病学与精神病学]