Frankel-A型急性颈脊髓损伤后继发的低钠血症(英文)

Secondary hyponatremia after Frankel Class A acute cervical spinal cord injury

目的 :总结急性完全性颈脊髓损伤继发低钠血症的发生率及变化规律 ,并推测其发生机制。方法 :回顾总结分析了本院 1992～ 1998年住院的 35例急性Frankel A型颈脊髓损伤患者的血尿生化变化及其时间变化规律。结果 :35例急性颈脊髓损伤患者伤后平均 (2 .8± 1.8)d入院 ,平均住院时间 (5 2± 13)d。低钠血症发生率10 0 % ,低钠血症于伤后 (4 .5± 1.2 )d开始 ,(14± 3)d达高峰 ,15例 (4 2 .88% )出院时低钠血症仍未恢复。此外 ,还可出现高碳酸血症、氮质血症、多尿以及尿钠排出量明显增多等变化 ,而血钾的变化始终在正常范围内波动。结论 :严重、顽固的低钠血症是颈脊髓损伤后极为常见的并发症 。

Objective: To define the occurrence rate, time course, and potential mechanism of hyponatremia in patients after Frankel Class A acute cervical spinal cord injury. Methods: Analysis of data obtained from a retrospective review of blood and urine records of 35 hospitalized cases from 1992 to 1998. Results: Patients were admitted after (2.8±1.8) days postinjury and had been hospitalized for (52±13) days. Hyponatremia, the occurrence rate of which was 100%, developed at a mean time of (4.5±1.2) days postinjury, reached its nadir at the end of (14±3) days and recovered to normal at (39±10) days. Fifteen (42.88%) cases did not recover from hyponatremia in the hospitalized period. Patients were suffering from hypercapnia, hypernitremia, polyuria, and hyper natriuresis besides kalemia. Conclusion: Severe and obstinate hyponatremia is a very common complication of cervical spinal cord injury. The mechanism may be related to the Cerebral Salt Wasting Syndrome.