重型颅脑损伤后脑性盐耗综合征36例分析

Analysis of 36 cases of cerebral salt wasting syndrome after serious cerebral injury

目的分析重型颅脑损伤病人并发脑性盐耗综合征的病因、发病机制,探讨切实有效的治疗方法。方法对我院2003年1月—2011年10月间救治的重型颅脑损伤合并脑性盐耗综合征的36例病人的临床表现及实验室指标进行回顾分析。结果除1例死于家属放弃治疗外,其余35例并发脑性盐耗综合征的病人经补液和补盐治疗,其低血钠、低血容量症状完全恢复。结论意识状态改变及低血钠、高尿钠、低血容量是脑性盐耗综合征的临床特点,补液和补盐治疗安全有效。大部分患者可在3周内症状消失,得以恢复。

Objective To investigate the etiology and pathogenesis of cerebral salt wasting syndrome after serious cerebral injury and analyze the effective treatment. Methods The clinical manifestations and laboratory index from 36 cases of patients with cerebral salt wasting syndrome after serious cerebral injury during January 2003 to October 2011 were retrospective analyzed. Results The symptoms of low serum sodium and hypovolemia of 35 cases with cerebral salt wasting syndrome were recovered after fluid-supplement therapy and salt intake except 1 case died of giving up treatment by his family. Conclusion Changes of consciousness,hyponatremia,high urinary sodium and hypovolemic are clinical characteristics of cerebral salt wasting syndrome.Fluid-supplement therapy and salt intake are safe and effective.Symptoms of most patients disappeared in 3 weeks and recovered.