CAJ | 학술논문

目的回顾性总结急性颈脊髓损伤后低钠血症的发生特点,并分析其可能的发生原因,以及脊髓损伤严重程度、性别、年龄等因素对血钠变化的影响.方法研究对象为2005年6月至2011年3月急诊收治的一组颈椎外伤患者,排除合并颅脑外伤及慢性疾病的患者,入选病例分为完全性脊髓损伤组、不完全性脊髓损伤组及无神经功能障碍组,回顾性分析各组病例的血钠变化情况.结果入选病例共102例,男83例,女19例；年龄17～68岁,平均45.6岁.完全性脊髓损伤组23例,不完全性脊髓损伤组60例,无神经功能障碍组19例.共发生低钠血症共39例,完全性脊髓损伤组15例(65％),不完全性脊髓损伤组23例(38％),无神经功能障碍组1例(5％).低钠血症发生率在三组间两两比较,差异有统计学意义,完全性脊髓损伤组低钠血症的发生率明显高于不完全性脊髓损伤组和无神经功能障碍组.Logistic逐步回归分析结果显示低钠血症与患者脊髓损伤程度有明确相关关系,而与患者的年龄、性别、脊髓损伤节段无相关关系.结论急性颈脊髓损伤后具有较高的低钠血症发生率,虽然影响钠盐平衡的因素及相互作用非常复杂,但颈脊髓损伤致自主神经功能障碍、神经内分泌功能异常以及血液动力学改变可能是导致颈脊髓损伤后电解质系统异常的重要原因.
목적 회고성총결급성경척수손상후저납혈증적발생특점,병분석기가능적발생원인,이급척수손상엄중정도、성별、년령등인소대혈납변화적영향.방법 연구대상위2005년6월지2011년3월급진수치적일조경추외상환자,배제합병로뇌외상급만성질병적환자,입선병례분위완전성척수손상조、불완전성척수손상조급무신경공능장애조,회고성분석각조병례적혈납변화정황.결과 입선병례공102례,남83례,녀19례；년령17～68세,평균45.6세.완전성척수손상조23례,불완전성척수손상조60례,무신경공능장애조19례.공발생저납혈증공39례,완전성척수손상조15례(65％),불완전성척수손상조23례(38％),무신경공능장애조1례(5％).저납혈증발생솔재삼조간량량비교,차이유통계학의의,완전성척수손상조저납혈증적발생솔명현고우불완전성척수손상조화무신경공능장애조.Logistic축보회귀분석결과현시저납혈증여환자척수손상정도유명학상관관계,이여환자적년령、성별、척수손상절단무상관관계.결론 급성경척수손상후구유교고적저납혈증발생솔,수연영향납염평형적인소급상호작용비상복잡,단경척수손상치자주신경공능장애、신경내분비공능이상이급혈액동역학개변가능시도치경척수손상후전해질계통이상적중요원인.
Objective To analyze the incidence and possible etiological factors of hyponatremia after acute cervical spinal cord injury (CSCI),and evaluate the effect of severity of CSCI,age,sex and injured segment on hyponatremia.Methods From June 2005 to March 2011,a series of patients with CSCI caused by cervical vertebras trauma were treated in our department.Except patients combined with craniocerebral injury or chronic diseases,other patients were divided into three groups:complete CSCI group,incomplete CSCI group and no neurological disorder group.Concentration of natrium in blood in all patients was analyzed respectively.Results All 102 patients (83 males,19 females) were selected with an average of 45.6years old.There were 23 patients with complete CSCI,60 with incomplete CSCI and 19 with no neurological disorder.Hyponatremia was found in 15 patients in complete CSCI group,23 patients in incomplete CSCI group and 1 patient in no neurological disorder group.The incidence of hyponatremia was significantly different between three groups,among which the complete CSCI group had the highest incidence.Multiple linear regression analysis showed hyponatremia was obviously correlated with the injury degree of spinal cord,but not correlated with the age,sex and injury segment of the patients.Conclusion Hyponatremia is a common complication in patients suffered from CSCI.Although the balance of natrium in blood is very complicated and influenced by many factors,autonomic nerve system and neuroendocrine system dysfunction,and hemodynamic changes after CSCI may play a key role in happening of electrolytical abnormality.