重型颅脑损伤后低钠血症的临床分析

Clinical analysis of hyponatremia after severe craniocerebral injury

目的探讨重型颅脑损伤(SCI)后低钠血症的病因、发病机制及其防治。方法分析97例重型颅脑外伤后低钠血症患者的发生发展因素及临床诊治与转归情况。结果抗利尿激素不适当分泌综合征(SIADH)、脑盐耗综合征(SCWS)和其他类型的低钠血症在恢复时间及治愈率方面差异均无统计学意义,而预后与病情轻重有密切关系,病情越重(GCS评分越低),低钠血症发生率越高,低钠血症越严重,病死率越高。结论对SCI患者应密切监测血钠浓度,早期发现并鉴别低钠血症的类型,及时而有针对性地治疗低钠血症对改善预后具有重要意义。

Objective To approach the causes,pathogenesis,preventions and treatments of hyponatremia after severe craniocerebral injury （SCI）. Methods Various kinds of influenced agents of hyponatremia were analyzed on 97 patients after SCI. The causes,pathogenesis,preventions and treatments were studied. Results There were no significant difference among the syndrome of inappropriate secretion of antidiuetic hormone（SIADH）,cerebra salt wasting syndrome（CSWS） and other types of hyponatremia in recovery time and cure rate. The prognosis had intimate relation with the patient＇s condition. The more severe the patient＇s condition was, the higher the incidence of hyponatremia occurred. The lower the natrium in blood SIADH was,the higher the fatality rate was. Conclusion The blood natrium concentration on SCI must be intimately monitored. It is very important to find and treat hyponatremia early for improving the prognosis.