神经外科病人低钠血症的病因分析

目的：本研究通过对神经外科低血钠病人ＡＤＨ与ＡＮＦ放免测定，以及血离子等生化指标的监测，结合补钠实验，进而确定病因，以改进神经外科低钠血症病人的诊断及治疗。方法：随机选１００例低血钠症病人，另选３０例正常人做为对照组。低钠病人逐日监测血钠，血钾，血ＢＵＮ，Ｃｒｅ，２４ｈ尿钠，红细胞压积，血红蛋白浓度。

THE STUDY ON THE PATHOGENY OF NEUROSURGICAL HYPONATREMIA

Objectives:Using immunoassay of serum ADH and ANF and monitoring of plasma electolytes and biochemical data,along with the test of sodium supplement,we aimed to establish the pathogenesis and improve the diagnosis and therapy of neurosurgical patients with hyponatremia Methods:100 neurosurgical patients with hypontremia were selected randomly Besides this,there was a normal group( n =30) Following data were observed:serum ADH,ANF,plasma electrolytes(Na +,K +),BUN,Cre,urine sodium/24h,hematocrit,protein concentration 100 neurosurgical patients with hyponatremia were divided into 3 grorps:nutritious hyponatremia group( n =86),SIADH group( n =6),CSWS group( n =8) Results:Serum ADH level was markedly elevated in CSWS group ( P <0 05) The protein concentration and hematocrit in CSWS were higher than those in SIADH( P <0 05) SIADH occured earlier than CSWS( P <0 05) Conclusions:Most of neurosurgical patients with hyponatremia were due to nutritious hyponatrimia SIADH occurred less frequently than CSWS SIADH occurred in the first week following brain injury or operation,while CSWS appeared one week later Elevated serum ADH level was the chief feature of SIADH,and increased plasma ANF level was the principle charateristics of CSWS As it was hypovolemic hyponatremia in CSWS,serum potassium,protein concentration and hematocrit presented a rising trend