重型颅脑损伤后中枢性低钠血症的诊治分析

DIAGNOSIS AND TREATMENT OF CENTRAL HYPONATREMIA AFTER SERIOUS CEREBRAL INJURY

目的 重点探讨重型颅脑损伤患者并发脑性盐耗综合征的病因、发病机制及诊治方法。方法 根据患者临床表现及实验室检查指标 ,回顾性分析重型颅脑损伤后 1 4 2例低钠血症患者 ,其中 1 2例确诊为脑性盐耗综合征并进行治疗。结果 1 1例治愈 ,1例未能坚持治疗死于低血钠症。结论 低血钠、高尿钠、低血容量及意识状态改变是脑性盐耗综合征的诊断依据 ,补充钠盐和血容量是安全有效的。

Objective To discuss the pathogenesis,pathology,diagnosis and treatment of cerebral salt wasting syndrome (CSWS) in serious cerebral injured patients. Methods Based on clinical presentation and laboratory results,12 cases of CSWS after serious cerebral injury were analyzed retrospectively and the effective therapy was provided. Results In this series,11 cases were cured and 1 case died. Conclusion Hyponatremia,hypematruria,hypovolemia and changes of consciousness are main signs to diagnose CSWS.Salt replacement is safe and effective in the treatment of CSWS.