颅脑损伤合并高钠血症63例临床分析

Analysis of 63 Cases of Craniocerebral Injury Complicated with Hypernatremia

目的探讨颅脑损伤后合并高钠血症的临床治疗及高钠血症对预后的影响。方法回顾分析该院2007年1月—2014年12月间收治的重型颅脑损伤合并高钠血症63例患者临床资料,对比血钠高低对死亡率的影响,对比控制尿量组与非控制尿量组血钠恢复时间。结果轻度高钠组、中度高钠组、重度高钠组分别有17例、24例、22例,各组的死亡率分别为29.4%、45.8%、63.6%,轻度高钠组与重度高钠组间相比,差异有统计学意义(P<0.05)。控制尿量组28例,非控制尿量组18例,两组的血钠恢复正常所需的平均天数分别为(4.57±1.86)、(6.38±1.49),两组相比差异有统计学意义(P<0.05)。结论颅脑损伤合并高钠血症血钠值越高,死亡率越高,除常规治疗外,控制尿量可明显缩短血钠恢复的时间。

Objective To discuss the clinical treatment of craniocerebral injury complicated with hypernatremia and the impact of Hypernatremia on its prognosis. Methods The clinical data of 63 patients with severe craniocerebral injury complicated with hypernatremia in the Department of Neurosurery of our hospital were retrospectively analyzed. The relationships between serum sodium level and the mortality were studied, and serum sodium recovery time was compared between the urine-output-control group and non-urine-output-control group. Results There were 17 cases, 24 cases, 22 cases in the mild, moderate and severe hypernatremia group with the mortality rate of 29.4%, 45.8% and 63.6%, respectively, and the difference between mild and severe hypernatremia group was statistically significant, P〈0.05. There were 28 cases and 18 cases in the urine-output-control group and nonurine-output-control group, respectively, with average serum sodium recovery time of 4.57 ±1.86、6.38±1.49, respectively, and the difference was statistically significant, P〈0.05. Conclusion In patients with craniocerebral injury complicated with hypernatremia,high serum sodium level result indicates high mortality rate. In addition to routine therapy, the limitation of urine output can short-en the serum sodium recovery time.