适应障碍继发低钠血症的访谈与治疗

本文目的是通过报道病例诊疗过程,呈现适应障碍继发低钠血症的临床诊疗思路及治疗方案的制定。咨客是一位54岁已婚男性,因为管理企业压力大,生活没有规律、经常熬夜逐渐出现失眠,予以SSRIs类药物(百忧解、左洛复)治疗后出现肢体乏力、懒言少语、轻体力劳动以后就会感到疲乏,化验检查明确有低钠血症,经本次咨询,被诊断为适应障碍继发低钠血症。建议采用生物-心理-社会综合干预方法,鼓励咨客加强运动,口服NaSSA类抗抑郁药米氮平缓解焦虑、阻止水盐代谢,限制液体摄入量,心理治疗推荐正念减压治疗。

Interview and treatment of hyponatremia secondary to adaptive disorders

The purpose of this article was to present the clinical diagnosis and the treatment ideas of adaptation disorders through reporting detail case study. The patient was a 54-year-old married men. He had a irregular life, often stayed up late and gradually appeared insomnia. He was prescribed with SSRIs medication (Prozac, Zoloft), but took medicine made him short-spoken, often felt tired after light physical labor. Then he was found to have hyponatremia by laboratory tests. After the consultation, he was diagnosed with hyponatremia secondary to adjustment disorder. Biological-psychological-social integrated intervention was recommended including emphasis on exercise, with the NaSSA antidepressant Mirtazapine taken orally to relieve anxiety. Meanwhile, a low-salt diet which could prevent water and salt metabolism was recommended. Psychotherapy recommendation was mindful stress reduction.