急性中枢性尿崩症临床经过和治疗评估

Clinical characteristics and treatment evaluation of patients with acute central diabetes insipidus

目的 调查分析急性中枢性尿崩症的临床过程和疗效。 方法 回顾性总结 1997年 5月～ 1999年 12月住我院PICU的 16例急性中枢性尿崩症患儿临床资料。 结果 所有病例均继发于脑损伤和应用垂体加压素治疗 ,其剂量为 0 0 0 0 3～0 0 0 65U/(kg·min) ,治疗时间为 5小时～ 18天 ,平匀 2 8 5小时。治疗目标达到 :尿量 2～ 3ml/(kg·h) ,尿比重 1 0 10～ 1 0 2 0 ,血钠 14 0～ 14 5mmol/L。存活 3例 ( 19% ) ,死亡 13例 ( 81% )。 结论 垂体加压素治疗急性中枢性尿崩症对于减少尿量和纠正高钠血症有显著效果。

Objective To investigate the etiology,clinical process and treatment efficacy of acute central diabetes insipidus(CDI).Methods Sixteen children with acute CDI admitted to our pediatric intensive care unit(PICU)from May 1997 to December 1999 were identified and analyzed retrospectively.Results All patients diagnosed with acute CDI were secondary to various brain injuries and were treated with aqueous vasopressin.The dose of aqueous vasopressin were ranged from 0\^0003 to 0\^0065U/(kg·min) and treated for 5 hours to 18 days,av 28\^5 hours.The therapeutic goals included:urine output 2～3 ml/(kg·h), urine specific gravity 1\^010～1\^020 and serum sodium 140～145 mmol/L.Three cases were survived (19%) and thirteen cases were died (81%).Conclusion The vasopressin was used by us for the management of CDI.It is generally efficacious in decreasing urine output and serum sodium level.