老年患者颈髓损伤后低钠血症的临床分析

Clinical analysis of hyponatremia after acute cervical spinal cord injury in the elderly

目的探讨老年急性颈髓损伤导致低钠血症患者的病因、发病机制及治疗。方法回顾性分析总结2006年5月至2011年3月52例中老年急性颈髓损伤患者，其中男性41例，女性11例，年龄50-78岁（平均68．2岁），所有患者均存在不同程度的低钠血症（血钠〈135mmol／L），根据血钠水平将患者分组，分析不同因素在低钠血症中的表达。采用SPSS13．0统计软件进行统计学处理。结果轻度低钠血症14例，中度36例，重度2例。50例患者经扩容、补钠或限水补钠等治疗后症状缓解，2例患者因高位颈髓损伤伴严重肺部感染呼吸衰竭死亡。不同损伤程度患者血钠水平差异有统计学意义（P〈0．05），血钠水平与年龄呈负相关（r〉1）。结论低钠严重程度与颈髓损伤程度、年龄等因素相关，在积极治疗原发损伤的同时，应区分低钠血症发生机制，从而制定相应治疗方案。

Objective To explore the pathogen and treatment methods ofhyponatremia after acute cervical spinal cord injury in the elderly. Methods A retrospective review of 52 cases with acute cervical spinal cord injury complicated with hyponatremia between May. 2006 and Mar. 2011 was undertook（blood natremia〈135mmol/L）. There were 41 males and 11 females, with the average age of 68.2 years（from 50 years to 78 years）. The patients were divided into different groups the cases according to the degree of blood natremia. The expressions of different factors on hyponatremia were analyzed. The clinical results were evaluated using SPSS 13.0. Results There were 14 cases of suffered with mild hyponatremia, 36 cases with moderate hyponatremia and 2 cases with severe hyponatremia. Blood natremia of 56 patients with light to moderate hyponatremia raised to normal, 2 patients with severe hyponatremia died of infection and respiratory failure. The blood natremia was siginificantly different between complete quadriplegia and incomplete quadriplagia（P〈0.05）. The blood natremia had a negative correlation with age （r〉1）. Conclusion The severity of hyponatremia of cervical spinal cord injury is correlative with severity and age. Individualized treatment should be made accroding to different environments.