颅脑损伤后低钠血症的临床诊治分析

Analysis of diagnosis and treatment of craniocerebral injury with central hyponatremia

目的:探讨颅脑损伤尝发中枢性低钠血症的临床特点、病因、诊断及治疗。方法:回顾79例颅脑损伤后中枢性低钠血症患者的临床资料及相应的诊断和治疗进行分析。结果:79例均有相似的临床表现和实验室检查结果。65例行中心静脉压(CVP)检查,47例<5 cmH2O,15例>12cm H2O。55例予补钠、补液治疗,低钠血症得到纠正,24例予限水治疗,低钠血症得到纠正。结论:颅脑损伤后中枢性低钠血症有脑性盐耗综合征(CSWS)和抗利尿激素分泌异常综合征(SIADH)两类,对其进行正确诊治能降低颅脑损伤患者的致残率和病死率。

Objective： To discuss the cause, diagnosis and treatment of hyponatremia in cerebral injured patients. Methods： Analyzing the clinical data, diagnosis and the treatments about 79 patients with subsequent hyponatremia of central origin after eraniocerebral injury. Results： 79 eases show the similar results on clinical manifestation and laboratory examination. Among 65cases examined with CVP,47 cases 〈 5em H20, and 15 cases 〉 12cm H20.55 patients with central hyponatremia recover by complementing salt and water, and 24 patients are cured by limiting intake of water. Conclusion： Central hyponatremia after craniocerebal injury includes CSWS, SIADH, the correct diagnosis and the proper treatments are important to decline the disabled and mortality rate.