ICU内高钠血症病因及治疗的临床评价

Clinical evaluation of etiology and treatment of hypernatremia in ICU

目的分析重症监护病房(ICU)内患者发生高钠血症的原因,并探讨高钠血症的治疗方法及其治疗效果。方法于2014年1月~2017年1月期间,选取我院ICU收治的200例危重患者进行回顾性研究,根据患者在ICU内是否发生高钠血症,将患者分为高钠血症组、无高钠血症组,比较两组ICU患者的临床资料,对导致ICU患者发生高钠血症的危险因素进行单因素分析、多因素Logistics线性回归分析。对高钠血症患者的临床治疗方法进行总结,对其转归情况进行观察。结果 200例ICU患者中,共有42例患者发生高钠血症,高钠血症发生率为21.00%。经单因素分析、多因素Logistics线性回归分析后明确,血容量不足、钠离子输入过多、APACHE II评分过高是导致ICU患者发生高钠血症的危险因素。转归情况方面,经治疗后,高钠血症患者的APACHE II评分均明显降低(P<0.05),其血钠水平也明显降低(P<0.05),且其各项生命体征均可见明显改善(P<0.05)。结论 ICU患者容易受到血容量、钠离子输入、APACHE II评分等因素的影响而发生高钠血症,临床上应针对患者的原发病及其病因进行对症治疗,以纠正血钠紊乱,改善生命体征。

Objective To analyze the causes of hypernatremia in patients with intensive care unit(ICU),and toexplore the treatment methods and effects of hypernatremia.Methods From January2014to January2017,200cases of critically ill patients of ICU in our hospital were selected and studied retrospectively,according to the ICUpatients whether or not had hypernatremia,the patients were divided into hypernatremia group and non hypernatremiagroup.The clinical data were compared between two groups of patients with ICU,leading to the the risk factors of ICUpatients with hypernatremia were analyzed by univariate analysis and multivariate Logistics regression analysis.Theclinical treatment methods of hypernatremia patients were summarized,and the prognosis was observed.ResultsIn the200patients with ICU,there was42cases of hypernatremia patients,and the incidence of hypernatremia was21%.After single factor analysis and multivariate Logistics linear regression analysis,it is clear that the lack of bloodvolume,excessive input of sodium ions and excessive APACHE and II score are the risk factors for hypernatremiain ICU patients.After the treatment,the APACHE II scores of the hypernatremia patients was significantly lower(P<0.05),and the blood sodium levels was significantly lower(P<0.05),and all the vital signs were obviouslyimproved(P<0.05).Conclusion ICU patients are easily affected by the blood volume,sodium ion input andAPACHE II score factors and hypernatremia,clinicians should be symptomatic treatment for primary disease andetiology of patients,in order to correct the blood sodium disorders,improve the signs of life.