重症监护病房内高钠血症的常见原因及治疗策略

The Common Reasons and Clinical Therapy Strategies of Hypernatremia in SICU

目的:分析外科重症监护病房(SICU)内高钠血症的可能原因及合理治疗策略。方法:回顾性分析2002 年1月至2003年12月本科高钠血症患者的临床资料。结果:高钠血症病死率68%。发生高钠血症当日的急性生理学与慢性健康状况(APACHEⅡ)评分显著高于人科第二日的APACHEⅡ评分(P<0.01);合并脑损伤患者的高钠血症发生率(29%)显著高于不合并脑损伤患者(13%),(P<0.01)。结论:SICU内高钠血症主要见于合并脑损伤的患者;医源性因素是发生高钠血症的原因之一;高血钠对疾病的转归有不利影响,故侧重针对各种危险因素加以预防及降低高钠血症十分重要。

Objective：To analyze the possible reasons and rational therapy strategy of hypematremia in surgical intensive care unit （SICU）. Methods：The patients who were admitted to the SICU from Jan 2002 to Dec 2003 were analyzed retrospectively. Results：The mortality of hypematremia patients was 68%. The acute physiology and chronic health evaluation Ⅱ（APACHE Ⅱ） in first day after onset of hypematremia were significantly higher than those of second day（P〈0.01）; the incidence rate of hypematremia in patients complicated with cerebral lesion were much higher（29%） than those of without（13%）, （P〈0.01）. Conclusions： Hypematremia in SICU are mainly seen in patients complicated with cerebral lesion,iatrogenic factor is one reason of it. Hypematremia has bad impact on prognosis of disease, so more attention should be paid to prevent and decrease hypematremia in patients with high risk.