婴幼儿腹泻病并低钠血症神经系统表现

The neurologic aspects of hyponatremia associated with infantile diarrheal diseases

目的：探讨婴幼儿腹泻病并低钠血症神经系统表现的特征。方法：分析２１例婴幼儿腹泻病并低钠血症的临床特征及电解质紊乱。结果：治疗前所有病儿均有低钠性脑病的症状和体征，包括恶心、呕吐、不安、嗜睡、癫痫发作及昏迷，其中１例表现低钠性抽搐，系快速饮入大量低渗水致水中毒后出现癫痫连续状态和呼吸衰竭。结论：常规剂量抗癫药难以控制癫痫发作，用高渗盐迅速控制其发作，纠正钠紊乱比抗癫痫药更有效。

Objective :To study the neurologic aspects of clinical features of hyponatremia associated with infantile diarrheal diseases. Methods : Clinical features and electrolytic disturbances were investigated in 21 hyponatremic cases of infantile diarrheal diseases with moderate to severe dehydration. Results: Before treatment, all the cases presented with some signs and symptoms of hyponatremic encephalopathy,including nausea, vomiting,restlessness,leathargy,seizures and coma.One of them had hyponatremic convulsion from water intoxication caused by rapid intake of large volume of hypotonic water,who developed late status epileptics and respiratory failure. Conclusion:The seizures were more difficult to control with routine dose of anticonvulsants and resolved promptly after administration of intravenous hypertonic saline.Correction of undedlying sodium disturbance is more effective than the use of anticonvulsants.