急性脊髓损伤患者并发低钠血症的危险因素分析及护理

Risk Factors of Acute Spinal Cord Injury Patients Complicated with Hyponatremia and Nursing Strategy

目的探讨急性脊髓损伤患者并发低钠血症的危险因素,以提供针对性的护理干预措施,提高护理质量,改善患者预后。方法回顾性分析121例确诊为急性脊髓损伤患者,根据有无并发低钠血症将患者分为两组,分析年龄、性别、损伤平面、完全截瘫、损伤严重程度、精神状态、甘露醇使用、激素使用、高热、腹泻、合并感染、合并颅脑损伤及血糖、血钾值等指标对其发生的影响,采用单因素分析和Logistic多元回归分析。结果脊髓损伤患者低钠血症发生率为43.8%,多因素Logistic回归模型分析显示:高热、合并颅脑损伤是低钠血症发生的独立危险因素(P<0.05)。结论高热和合并颅脑损伤是急性脊髓损伤患者并发低钠血症的独立危险因素。应针对危险因素早期加强护理评估和护理干预,降低急性脊髓损伤后低钠血症的发生率。

Objective To investigate the risk factors and nursing measures of acute spinal cord injury with hyponatremia.Methods One hundred and twenty-one patients diagnosed as acute spinal cord injury were analyzed retrospectively.And the patients were divided into two groups according to whether complicated with hyponatremia.Multiple possible influence factors including age,gender,injury level,complete paraplegia or not,Frankel classification,mental status,use of mannitol,use of glucocorticoid,hyperthermia or not,diarrhea or not,whether combined with infection,whether combined with brain injury,blood glucose and serum potassium were studied by univariate analysis and multivariate Logistic regression analysis.Results Hyponatremia occurred in 43.8% of the patients with spinal cord injury.Multivariate Logistic regression analysis showed that hyperthermia（OR=1.927,P=0.048） and combined with brain injury were independent risk factors of hyponatremia（OR=3.132,P=0.042）.Conclusion Hyperthermia and combined with brain injury are independent risk factors for acute spinal cord injury complicated with hyponatremia.Early nursing evaluation and intervention measures should be taken to reduce the incidence of hyponatremia in patients with acute spinal cord injury.