创伤性脑损伤后低钠血症的危险因素分析

Clinical analysis of hyponatremia following traumatic brain injury

目的探讨创伤性脑损伤(TBI)后低钠血症的发生特点及其危险因素。方法回顾性分析我院136例中、重度TBI患者的临床资料,主要包括年龄、性别、损伤类型、GCS评分、手术、是否有脑水肿和颅底骨折等,并对上述因素与低钠血症的发生进行卡方检验和多因素Logistic回归分析。结果 136例中、重度TBI患者中有56例发生低钠血症,经多因素Logistic回归分析,TBI后低钠血症的发生与患者的年龄、性别、损伤类型、是否开颅手术无关,而与患者的GCS评分、是否合并脑水肿或颅底骨折关系密切。结论 TBI患者如GCS≤8分、合并有脑水肿或颅底骨折,则易于发生低钠血症,需提前采取预防措施。

Objective To investigate the incidence and etiological factors of hyponatremia following traumatic brain injury （TBI） and analyze the relationship between hyponatremia and the patient’s age, gender, type of injury, Glasgow coma scale （GCS）, operation and computerized tomography （CT） scan of head. Methods Clinical data of 136 pa-tients with moderate or severe TBI in our hospital were analyzed retrospectively, including patient’s age, gender, type of injury, GCS, operation, brain edema and basal skull fracture. The relationship between clinical data and hyponatremia were analyzed statistically by Chi-square test and multivariate Logistic regression analysis. Results There were 56 pa-tients with hyponatremia in 136 patients （81 males） with moderate or severe TBI. Multivariate Logistic regression analysis showed that hyponatremia secondary to TBI was not associated with patient’s age, gender, type of injury and operation or not. However, there was a high correlation between hyponatremia following TBI and clinical characteristics of TBI at ear-ly stage, such as GCS, brain edema and basal skull fracture. Conclusions Patients with TBI is more likely to develop hy-ponatremia when they have the following clinical factors, such as GCS≤8, brain edema or basal skull fracture. Preven-tive measures should be given to these patients in advance.