放射性脑损伤并发低钠血症的临床特点及相关处理

Diagnosis Characteristic and Treatment of Radiation-induced Brain Injury with Hyponatremia

目的:探讨放射性脑损伤并发低钠血症的临床特点、发病原因和治疗方案。方法:采用回顾性分析的方法,收集2012年1月到2016年12月在中山大学孙逸仙纪念医院神经科住院并诊断放射性脑损伤同时合并有低钠血症的病人资料,总结其临床特点、治疗方法及治疗结果。结果:共收集放射性脑损伤并发低钠血症165例,头痛、恶心呕吐、全身乏力为最常见的临床表现。按血钠降低程度分为轻度低钠组(135 mmol/L>Na^+≥130 mmol/L,99例)和中重度低钠(Na+<130 mmol/L,66例)组,首要病因均为钠摄入不足,其次为钠丢失过多,其他原因还包括促甲状腺素激素缺乏、促肾上腺皮质激素缺乏、肺部感染以及药物因素。结论:放射性脑损伤合并低钠血症,要鉴别主要的致病机制,有针对性地预防和治疗放射性脑损伤所并发的低钠血症,并要对中重度低钠患者进行定期随访。

Objective：To summarize the diagnosis and treatment of radiation-induced brain injury with hyponatremia. Methods： Data during the period 2012 to 2016 from radiation-induced brain injury database in Sun Yat-sen Memorial Hospital was analyzed, 165 patients were involved. The clinical data of radiation-induced brain injury with hyponatremia （Na 〈 135mmol/L）was searched. Results： The 165 patients diagnosed with hyponatremia were divided into two groups that one is mild while another is moderate to serious. Inadequate sodium intake as well as sodium lost is the main reason causing hyponatremia, while the other reasons are lacking TSH, and ACTH, pneumonia, medicine factors. Conclusion： Master sodium replenishment principle as well as treat the injury is the first-line treatment, and close postoperative follow-up is necessary.