烧伤后高钠血症的鉴别诊断及其防治

Differentiable Diagnosis and Treatment on Hypernatremia after Burned Patients

目的 探讨烧伤后不同原因所致高钠血症的鉴别诊断及其防治措施。方法 我科 1990 - 0 1～ 2 0 0 0 - 0 6烧伤后发生高钠血症的患者 2 8例 ,按其主要诱因分为感染组和非感染组。对其临床特点、化验结果、治疗及其预后情况进行分析。结果 非感染组高钠血症发生时间在伤后 3.1d,主要临床表现为精神兴奋 ,其血糖 (10 .2 2± 3.31) mmol/ L、血尿素氮 (8.0 5± 1.5 9) mmol/ L 较感染组血糖 (19.83± 10 .5 0 ) mmol/ L、血尿素氮 (8.5 4± 1.6 8) mmol/ L 低 (P<0 .0 1) ,治愈率为 94.12 %。感染组高钠血症发生时间为伤后 7.2 d,主要表现为精神抑制 ,治愈率为 9.0 9%。结论 只有鉴别不同原因所致高钠血症 ,并采取相应防治措施 ,方可减少治疗中失误。

Objective To investigate the differentiable diagnosis and preventive measuse of hypernatremia which caused by different precipitating factor after burn.Methods From Jan,1990 to Jun,2000,28 cases of hypernatremia postburm were compartmentalized of infected group and noninfected group according to primary precipitating factor in our department.To analysis its clinical characteristic,experimental examination、treatment and prognoses.Results The noninfected group occurred hypernatremia mean at 3.1days postburn,as contrast to 7.2days in infected group.The main symptom in noninfected group was mental excitement,and that of in another group was mental inhibit.Blood sugar and BUN in noninfected group were much lower than that in infected group (P<0.01),and the cure rate in noninfected group(94.12%) was significantly higher than that in infected group(9.09%).Conclusions It was suggested that differentiating hypernatremia ccurred by different precipitating factor and taking corresponding prevention measure may decrease errors in treatment.