创伤性颈脊髓损伤患者低钠血症的发生率及相关因素

Incidence and related factors of hyponatremia in patients with traumatic cervical spinal cord injury

目的探讨本地区创伤性颈脊髓损伤(traumatic cervical spinal cord injury,TCSCI)患者低钠血症的发生率及影响因素。方法选择2019年1月~2021年12月在该院就诊的TCSCI患者资料进行回顾性分析,记录患者的年龄、性别、损伤原因、严重程度(完全或不完全性脊髓损伤)和脊髓损伤水平、血清钠水平、治疗策略及低钠血症持续天数,观察是否低钠血症患者的临床资料差异。结果共有54例发生低钠血症,发生率为58.06%。单因素分析显示,低钠血症和非低钠血症患者性别、损伤原因、白蛋白水平差异均无统计学意义(P>0.05);两组患者年龄、损伤平面、ASIA分级、甲强龙冲击、神经源性休克、体温、合并感染、每日尿量等差异存在统计学意义(P<0.05)。多因素Logistic回归分析显示,完全性脊髓损伤和神经源性休克是TCSCI患者发生低钠血症的风险因素(P<0.05)。结论TCSCI后低钠血症发生率为58.06%,完全性脊髓损伤和神经源性休克是TCSCI患者发生低钠血症的风险因素,临床应早期监测TCSCI发生后的钠离子水平,以早发现、早期干预治疗。

Objective To investigate the incidence and influencing factors of hyponatremia in patients with traumatic cervical spinal cord injury(TCSCI).Methods The clinical data of TCSCI patients in our hospital from January 2019 to December 2021 were analyzed retrospectively.The patients’age,gender,cause of injury,severity(complete or incomplete SCI)and SCI level,serum sodium level,treatment strategy and days of injury hyponatremia were recorded.Whether the difference existed in the clinical data of patients with hyponatremia was observed.Results There were 54 cases of hyponatremia in this study,and the incidence rate was 58.06%.Univariate analysis showed that there was no significant difference in gender,injury cause and albumin between hyponatremia and non hyponatremia patients(P>0.05).There were significant differences in age,injury level,Asia grade,methylprednisolone shock,neurogenic shock,body temperature,coinfection and daily urine volume between the two groups(P<0.05).Multivariate logistic analysis showed that complete spinal cord injury and neurogenic shock were the risk factors for TCSCI patients(P<0.05).Conclusion The incidence of hyponatremia after TCSCI is 58.06%.Complete spinal cord injury and neurogenic shock are the risk factors for hyponatremia in patients with TCSCI.The level of sodium ion after TCSCI should be monitored early,as well as the early detection of hyponatremia and early intervention.