急性颈髓损伤并发低钠血症临床分析

Acute cervical spinal cord injury complicated with hyponatremia analysis of 16 cases

目的探讨急性颈髓损伤后低钠血症的临床特点和有效的治疗方法。方法回顾性分析急性颈髓损伤后低钠血症患者16例，男15例，女1例，年龄35．6（17～46）岁，高位颈髓（C4及C4以上）损伤4例，低位颈髓（C4以下）损伤12例，的临床资料。结果平均出现低钠血症时间为伤后（5．3±1．6）d，出现低钠高峰时间为伤后f7．9±2．1）d，低钠持续时间（18．7±5．1）d，最低血清钠浓度为（112．7±3．8）mmo]／L。所有患者均给予深静脉插管以补液及行中心静脉压监测，经限水、补钠等治疗后14例患者低钠血症纠正，2例患者自动出院。结论低钠血症原因是颈髓损伤发常见的严重并发症。通过严密监测患者血钠并维持钠代谢正平衡可纠正患者的低钠血症。

Objective To investigate the clinical characteristics, pathogenesis, and treatment of acute cervical spinal cord injury complicated with hyponatremia. Methods The clinical data of 16 patients of acute cervical spinal cord injury complicated with hyponatremia, 15 males and 1 female, aged 35.6 （17 ± 46）, 4 with the injury at C4 and above, and 12 with the injuries below C4, were retrospectively analyzed. Results With a duration of （18.9±5.1） days, hyponatremia occurred （5.3±1.6） days after the injury on average, and the peak time of occurrence of hyponatremia was （7.9 ±2.1） days following the injury. The lowest serum sodium level was （112.7 ±3.8） mmol/L. Central venous pressure was monitored in all patients by cannulation of the deep vein. After appropriate salt supplement and restriction of water intake, hyponatremia were improved in 14 patients and 2 patients were discharged against medical advise. Conclusion hyponatremia is one of the common severe complications of cervical spinal cord injury. Close monitoring and maintenance of sodium metabolism help correct this disorder.