蛛网膜下腔出血并发低钠血症及预后分析

Analysis of prognosis and hyponatremia after subarachnoid he morrhage

目的:探讨自发性蛛网膜下腔出血(SAH)急性期低钠血症的发生情况及其对预后的影响。方法:收集首次发病的急性期SAH病人76例,测定其血清钠,对发生低钠血症患者的预后及并发症进行分析。结果:SAH后低钠血症占同期自发性SAH的46.1%;并发低钠血症病人的死亡恶化率高于血钠正常的病人,有统计学意义(P﹤0.05),低钠血症患者发生血管痉挛及继发脑梗死、脑积水者也高于血钠正常者(P﹤0.05)。结论:SAH后低钠血症发生率很高;是预后差的危险因素;且与脑血管痉挛,脑积水关系密切。

Objective:To investigate the occurrence o f hyponatremia after spontaneous subarachnoid hemorrhage(SAH)during acute period and its effect on patient's outcome.Method:Serum sodium levels were measured in 76patients with SAH for the first time in acute period.The prognosis and complic ations in patients with hyponatremia after SAH were analyzed.Result:Hyponatremia after SAH was46.1%of subarachnoid hemorrhage at that period.The mortality and $$$$o r deterioration rate in the patients with hyponatremia were statistically higher than those in patients without hyponatremia(P<0.05).The percentage of cerebral infarct secondary to vasospasm and the percentage of hydrocephalus were also hi gher in patients with hyponatremia than in those with normonatremia(P<0.05).Con clusion:The incidence of hyponatremia after SAH is very high.Hyponatremia may be one of the risk factors resulting in poor outcome,and significantly associated with symptomatic vasospasm and hydrocephalus.