喉癌术后早期出现低钠血症的相关因素分析

Analysis of related factors of hyponatremia in early postoperative period after laryngeal cancer surgery

目的探讨喉癌患者手术后早期发生低钠血症的相关危险因素。方法回顾性分析徐州医科大学附属医院2018年9月~2020年3月收治的86例喉癌患者的临床资料,根据术后1周内是否存在低钠血症分为正常组和低钠组。对两组间年龄、病程、基础疾病、术前体质量指数(BMI)、血生化指标、分期、术后每日入液量等相关因素进行统计学比较。结果 86例患者术后发生低钠血症者26例,发生率为30.23%,其中重度2例,中度3例,轻度21例。两组间年龄、病程、基础疾病、分期、手术方式、出血量、术后引流量、术后平均每日入液量等无统计学差异;单因素分析发现术前BMI、血清白蛋白等,术后平均每日鼻饲总量、食盐鼻饲量,术后并发症有统计学差异(P<0.05);多因素分析发现术前BMI、术后每日鼻饲量、每日食盐摄入量是低钠血症发生的独立危险因素。结论术前BMI、术后每日鼻饲总量以及每日食盐鼻饲量与喉癌术后早期低钠血症发生有关;加强营养支持、补充钠盐摄入可降低低钠血症的发生率。

OBJECTIVE To investigate the risk factors of hyponatremia in early postoperative period after laryngeal cancer surgery.METHODS The clinical data of 86 patients with laryngeal carcinoma who underwent laryngectomy in our hospital from September 2018 to March 2020 were analyzed retrospectively.They were divided into normal group and hyponatremia group according to the presence of hyponatremia within one week after operation.The related factors such as age,course of disease,basic diseases,preoperative BMI,preoperative blood biochemical indexes,tumor stage,average daily fluid intake after operation etc were statistically compared between the two groups.RESULTS Hyponatremia occurred in 26 of 86 patients(30.23%),including severe in 2 cases,moderate in 3 cases and mild in 21 cases.There was no significant difference in age,course of disease,basic disease,tumor stage,mode of operation,bleeding volume,postoperative drainage,average daily fluid intake after operation etc between the two groups,but there were significant differences in preoperative BMI,serum albumin,average daily nasal feeding,average daily salt nasal feeding and postoperative complications between the two groups(P<0.05).Multivariate analysis showed that preoperative BMI,daily nasal feeding and daily salt intake were independent risk factors for hyponatremia.CONCLUSION Preoperative BMI,total daily nasal feeding and daily salt nasal feeding are related to the occurrence of early hyponatremia after laryngeal cancer surgery,and strengthening nutritional support and supplementing sodium intake can reduce the incidence of hyponatremia.