颈髓损伤并发低钠血症的病例分析

Analysis of cases with hyponatremia after acute cervical spinal cord injury

目的探讨颈髓损伤后低钠血症的发病机制和治疗方法。方法将28例颈髓损伤按颈髓损伤水平分为3组,观察血钠、尿量、血钾及尿比重等变化。结果28例均出现低钠血症,其中上颈髓损伤6例,血钠(122.51±13.34)mmol/L;中颈髓损伤14例,血钠(125.19±6.51)mmol/L;下颈髓损伤8例,血钠(130.18±7.24)mmol/L。结论颈髓损伤患者并发低钠血症,损伤水平越高,血钠越低。其发生机制多被解释为脑性耗盐综合征(CSW S)和抗利尿激素分泌异常综合征(SIADH)。

Objective To investigate the mechanism and the treatment of hyponatremia after acute cervical spinal cord injury. Methods Twenty-eight cases with acute cervical spinal cord injury were divided into three groups on the basis of the degree of injury. The serum sodium,urine amount,serum potassium and urine specific gravity of the cases were studied. Results All the cases showed hyponatremia. The serum sodium of 6 cases of the upper cervical spinal cord injury was（ 122.51 ± 13.34 ）mmol/L;the 14 cases of the middle cervical spinal cord injury, （ 125.19 ±6.51 ） mmol/L;the 8 cases of the lower cervical spinal cord injury, （ 130.18 ±7.24） mmol/L. Conclusion Many cases of the cervical spinal cord injury were accompanied by hyponatremia. The higher the degree of the injury,the lower the serum sodium. CSWS and SIADH are the mechanisms of this phenomenon.