医药前沿
醫藥前沿
의약전연
YIAYAO QIANYAN
2013年
31期
131-132
,共2页
杨勇灵%朱婕%杨彦妮%沈健
楊勇靈%硃婕%楊彥妮%瀋健
양용령%주첩%양언니%침건
低钠血症%脑性盐耗综合征%抗利尿激素分泌不当综合征%尿崩症
低鈉血癥%腦性鹽耗綜閤徵%抗利尿激素分泌不噹綜閤徵%尿崩癥
저납혈증%뇌성염모종합정%항이뇨격소분비불당종합정%뇨붕증
Hyponatremia%CSWS%SIADH%DI
目的：探讨神经外科患者并发低钠血症的原因、分类、诊断和治疗。方法收集6645例神经外科患者的临床资料，649例适合入选病例的标准，均在神经外科疾病基础上并发低钠血症，同时排除肝脏、肾脏、心脏、甲状腺等其他器质性疾病所致的低钠血症。分析649例低钠血症产生的原因，分类诊断及治疗方法。结果低钠血症发生率9.8%，其中，单纯性低钠血症550例，84.7%；脑性盐耗综合征（CSWS）51例，7.9%；尿崩症（DI）35例，5.4%；抗利尿激素不适当分泌综合征（SIADH）13例，2.0%。引起低钠血症神经外科疾病：血管瘤破裂致蛛网膜下腔出血121例，19.9%；颅内感染13例，17.5%；颅脑外伤296例，9.1%；高血压脑出血183例，8.4%；颅内肿瘤36例，6.7%。结论低钠血症是神经外科常见的并发症，发生的原因是：利尿过度或摄入不足引起的单纯性低钠、CSWS、DI、SIADH是引起低钠的原因。由于临床表现相似，加上基础上疾病的掩盖，临床上容易混淆，应仔细分析产生低钠的原因，做到早发现，针对不同的病因进行治疗。
目的：探討神經外科患者併髮低鈉血癥的原因、分類、診斷和治療。方法收集6645例神經外科患者的臨床資料，649例適閤入選病例的標準，均在神經外科疾病基礎上併髮低鈉血癥，同時排除肝髒、腎髒、心髒、甲狀腺等其他器質性疾病所緻的低鈉血癥。分析649例低鈉血癥產生的原因，分類診斷及治療方法。結果低鈉血癥髮生率9.8%，其中，單純性低鈉血癥550例，84.7%；腦性鹽耗綜閤徵（CSWS）51例，7.9%；尿崩癥（DI）35例，5.4%；抗利尿激素不適噹分泌綜閤徵（SIADH）13例，2.0%。引起低鈉血癥神經外科疾病：血管瘤破裂緻蛛網膜下腔齣血121例，19.9%；顱內感染13例，17.5%；顱腦外傷296例，9.1%；高血壓腦齣血183例，8.4%；顱內腫瘤36例，6.7%。結論低鈉血癥是神經外科常見的併髮癥，髮生的原因是：利尿過度或攝入不足引起的單純性低鈉、CSWS、DI、SIADH是引起低鈉的原因。由于臨床錶現相似，加上基礎上疾病的掩蓋，臨床上容易混淆，應仔細分析產生低鈉的原因，做到早髮現，針對不同的病因進行治療。
목적：탐토신경외과환자병발저납혈증적원인、분류、진단화치료。방법수집6645례신경외과환자적림상자료，649례괄합입선병례적표준，균재신경외과질병기출상병발저납혈증，동시배제간장、신장、심장、갑상선등기타기질성질병소치적저납혈증。분석649례저납혈증산생적원인，분류진단급치료방법。결과저납혈증발생솔9.8%，기중，단순성저납혈증550례，84.7%；뇌성염모종합정（CSWS）51례，7.9%；뇨붕증（DI）35례，5.4%；항이뇨격소불괄당분비종합정（SIADH）13례，2.0%。인기저납혈증신경외과질병：혈관류파렬치주망막하강출혈121례，19.9%；로내감염13례，17.5%；로뇌외상296례，9.1%；고혈압뇌출혈183례，8.4%；로내종류36례，6.7%。결론저납혈증시신경외과상견적병발증，발생적원인시：이뇨과도혹섭입불족인기적단순성저납、CSWS、DI、SIADH시인기저납적원인。유우림상표현상사，가상기출상질병적엄개，림상상용역혼효，응자세분석산생저납적원인，주도조발현，침대불동적병인진행치료。
Objective: Discussing the cause, classification, diagnosis and treatment of the neurosurgery patients complicated with hyponatremia. Method: Col ecting the clinical data of 6645 patients with neurosurgery in which 649 patients are suitable for the study standards: they al suffer from hypokalemia on the basis of neurosurgical diseases and to rule out the hyponatremia which results from liver disease, kidney disease, heart disease, thyroid disease or other organic diseases. To do analysis of the causes, classifications, diagnosis and treatments of the 649 patients with hyponatremia Results: The incidence of hyponatremia is 9.8%, and the simple hyponatremia holds 550 cases and it accounts for 85% of al the 649 cases; there are 51 cases of Cerebral Salt Wasting Syndrome(CSWS) accounting for 7.9%; 35 cases of Diabetes Insipidus(DI) accounting for 5.4%; 13 cases of Syndrome of Inappropriate Antidiuretic Hormone(SIADH) accounting for 2.0%. About causing the neurosurgical disease complicated with hyponatremia: 121 cases of Subarachnoid Hemorrhage(SAH) caused by rupture of hemangioma accounting for 19.9%; 13 cases of intracranial infection accounting for 17.5%; 296 cases of craniocerebral trauma accounting for 9.1%; 183 cases of Hypertensive Cerebral Hemorrhage accounting 8.4%; 36 cases of intracerebral tumor accounting for 6.7%. Conclusion: Hyponatremia is the common complication of neurosurgery. The cause is: excessive diuresis or insufficiency of intake result in simple low sodium and CSWS, DI and SIADH are the causes of low sodium. Due to similar clinical manifestation and the cover of basic diseases, it is clinical y confused. Therefore, to detect the diseases early and conduct treatments in accordance with difference causes, careful analysis of the cause of low sodium is needed.
