肝移植术后的低钠血症

Hyponatremia after liver transplantation

目的探讨肝移植术后低钠血症的原因及治疗。方法对肝移植术后发生低钠血症的27例患者的临床资料进行回顾性分析。结果25例在术后1周左右发生低钠血症,2例术前已有低钠血症,术后即发生严重低钠血症,一例患者发生急性低钠综合征;血钠为130～135mmol/L者10例,120～130mmol/L者12例,低于120mmol/L者5例;血钾、血磷及血钙均在正常范围;尿钠、钾、氯均在正常范围;5例患者测定腹水钠含量,均高于同时段血钠含量。治疗主要是通过胃肠和/或静脉补给高渗盐水。结论肝移植术后发生低钠血症的原因是多方面的,治疗上应去除导致低钠血症的原因,并持续、缓慢地补充高渗盐水。

Objective To explore the causes and treatment measures of hyponatremia after liver transplantation. Methods The clinical data of 27 patients with hyponatremia after liver transplantation were analyzed retrospectively. Results Among the 27 patients, postoperative hyponatremia occurred in 25 cases in about one week, and preoperative hyponatremia occurred in 2 cases and severe ~hyponatre -mia occurred immediate after operation. Acute hyponatremia occurred in one case. Blood natrium was 130 to 135 mmol/L in 10 cases, 120 to 130 mmol/L in 12 cases and less than 120 mmol/L in 5 cases. The levels of blood potassium, phosphor and calcium were all normal. Urinary natrium, potassium and chlorine levels were all normal. The ascites natrium level was higher than blood natrium at the same time. Hyponatremia was treated by supply of hypertonic saline via gastrointestine an/or veins. Conclusion Various causes could result in hyponatremia after liver transplantation. The hyponatremia was treated by supply of hypertonic saline constantly and slowly.