病毒性脑炎血清钠、钙水平与临床关系的探讨

A discussion on relationship of serum sodium、calcium and clinic for children with viral encephalitis

目的 为探讨小儿病毒性脑炎时血清钠、钙浓度的改变及临床意义。方法 入院后 12h内即用全自动生化分析仪测定血清钠、钙浓度。结果 低钠血症 115例 (46.3 7% ) ,高钠血症 10例 (4.0 3 % ) ,低钙血症 3 4例 (13 .71% ) ,4例高钠血症死亡。病毒性脑炎发生低钠血症的频率重症者明显高于轻症者 ,头颅CT或MRI提示脑损害组较正常组发生率高。结论 病毒性脑炎伴随的血清钠、钙异常不完全是治疗中的并发症 ,可能与病毒性脑炎脑损害的病理生理有关 ,1周内出现的高钠血症预示病情濒危 ,低钙血症可诱发或加重惊厥。因此 ,在使用脱水剂的同时 ,注意适当补充钠、钙等 ,维持电解质的平衡 。

Objective To discuss the change of serum sodium?calcium and clinical significance for children with viral encephalitis. Methods The level of serum sodium?calcium were measured by automatic biochemical analysis in 12 hours of admission.Results The patients with hyponatremia were 115(46.37%)?hypernatremia 10(4.03%)?hypocalcemia 34(13.71%) while 4 cases of hypernatremia died.The rate of severe patients with viral encephalitis was higer than those of mild′s .CT(MRI) hinted that children with brain damage were more than no brain damage′s. Conclusions All abnormity of serum sodium?calcium was not complication for children with viral encephalitis during the process of treatment,it probably related with pathophysiology of brain damage . Hypernatremia showed that the patients were in severe danger within one week;meanwhile hypocalcemia induced(aggravated) convulsion.Therefore, in order to maintain the balance of electrolyte and ensure the success of treatment,natrium or calcium should be supplied properly while drugs of dehydration applied.