肝硬化腹水并发低钠血症的临床分析

Clinical Analysis of Cirrhotic Ascites Complicated with Hyponatremia

目的探讨肝硬化腹水患者不同血清钠水平与病情严重程度的关系。方法回顾分析2008年7月-2010年6月收治47例肝硬化腹水并发低钠血症患者,根据其入院时血清钠水平分为低钠血症轻(A组)、中(B组)、重(C组)3组。比较肝硬化腹水患者不同血钠水平的腹水程度及疗效的关系、以及低钠程度与肝性脑病、肝肾综合征和死亡发生率的关系。结果与A组比较,B、C两组腹水量、肝性脑病、肝肾综合征及病死率明显增高,差异有统计学意义(P<0.05);对治疗的效果明显降低(P<0.05)。结论肝硬化腹水患者的血清钠水平与其病情程度具有紧密相关性,监测血清钠的水平可作为判断病情严重程度的重要指标之一,提示在临床上需重视预防、及时发现并治疗低钠血症。

Objective To investigate the relationship between serum sodium level and disease severity in patients with cirrhotic ascites complicated with hyponatremia.Methods The clinical data of 47 cirrhotic ascites patients complicated with hyponatremia treated between July 2008 and June 2010 were studied retrospectively.According to their serum sodium levels,the patients were divided into three groups： group A with light,B with moderate,and C with severe hyponatremia.We analyzed the relationship between ascites level based on different severity of hyponatremia and the curative effects.Furthermore,the relationships between hyponatremia severity and the incidence of hepatic encephalopathy,hepatorenal syndrome and mortality were also investigated.Results Compared with patients in group A,the volume of ascites,incidence of hepatic encephalopathy,hepatorenal syndrome and mortality were all significantly higher,while the curative effects were significantly lower for patients in groups B and C（P〈0.05）.Conclusions The serum sodium level in cirrhotic ascites patients is closely correlated with the disease severity.Monitoring the level can be used as an important indicator in determining the severity of the disease,which indicates that we should put more emphasis on the prevention,diagnosis and treatment of hyponatremia.