重型颅脑损伤并发抗利尿激素异常分泌综合征临床分析

Clinical analysis of syndrome of inapproprpriate of antidiuretic hormone with severe brain injury

目的:探讨重型颅脑损伤并发抗利尿激素异常分泌综合征(SIADH)机制,临床特征及治疗转归。方法:回顾分析17例颅脑损伤并发SIADH资料。结果:17例均有不同程度的脑挫裂伤和低钠、低氯血症、低渗血症及高尿钠症。结论:SIADH是由于下丘脑直接或间接损伤所致。治疗关键是严控摄入水量,适量补盐,将血钠控制在安全水平。

Objective To analyze the cause,the clinical feature and treatment of inappropriate secretion of antidiuretic hormone （SIADH） with severe brain injury.Methods To retrospectively analyse and sum up 17 patients treated for SIADH with severe brain injury. Results The 17 patients all had different extent in brain contusion,hy- ponatremia, low serum chlorine ,hyposmolality and high urine soduim. Conclusion SIADH is caused by injury to the hypothalamus directly or indirectly. The key of therapy is that patients should be controlled with vigorous water restriction and be given sodium properly. The goal serum sodium level should be safe.