急性颈髓损伤患者低钠血症的临床特点及治疗

Retrospective study of hyponatremia after acute cervical spinal cord injury

目的探讨急性颈髓损伤患者并发低钠血症的临床特点、发病机制及治疗方法。方法分析2003-01-2009-12合并低钠血症的急性颈髓损伤患者146例,其中39例轻度,64例中度,43例重度。对其临床特点及治疗进行分析。结果 103例轻中度低钠血症患者治疗10～14d后,血钠逐渐恢复正常。重度患者中,12例治疗2～3周后血钠恢复正常水平,22例虽有明显好转但未达到正常血钠水平;9例出现严重并发症死亡。结论低钠血症是急性颈髓损伤患者常见并发症,宜根据其不同发病机制分别选择治疗方法。

Objective To investigate the pathogenesis and treatment methods of hyponatremia after acute cervical spinal cord injury.Methods A retrospective study of 146 cases with acute cervical spinal cord injury complicated with hyponatremia from January 2003 to Dec 2009 was undertaken.According to the blood natremia level,the cases associated with hyponatremia were divided into 3 groups：mild（39 cases）,moderate（64 cases）and severe（43 cases）.The mechanism,treatment methods and therapeutic effects were evaluated in the different groups.Results There were 39 caseswith mild hyponatremia,64 cases with moderate hyponatremia and 43 cases with severe hyponatremia.Ten patients in the severe group had significant lethargy and impaired mental function symptoms.The blood natremia in patients with complete quadriplegia compared with incomplete cases had significant difference.One hundred and three cases with light to moderate hyponatremia had blood natremia raised to normal completely.Nine cases with severe hyponatremia died of fever,pneumonia orrespiratory failure.Conclusions Hyponatremia iscommon in the patients with acute cervical spinalcord injury.The treatment methods should besuited for the different mechanisms.