颅脑损伤后的脑性盐耗综合征22例临床分析

目的分析22例颅脑损伤后的脑性盐耗综合征(cerebral salt wasting syndrome,CSWS)的临床诊断和治疗体会。方法回顾性分析22例颅脑损伤患者CSWS的临床表现,患者平均年龄为(53.2±17.1)岁,中位发病时间11 d,中位病程11 d。结果所有病例均符合CSWS诊断金标准,其中8例患者血清钠<120 mmol/L,为重症患者,临床表现为短期内出现意识障碍。轻、中症患者临床表现为消化道症状和渐进性意识下降。经适当补充液体量,应用速尿,白蛋白和积极补钠等综合治疗,4例重症患者死亡,其余治愈。结论CSWS在颅脑损伤后并不少见,诊断并不困难,但需提高警惕。治疗的重点是预防和控制脑水肿。

Clinical analysis on 22 cases of cerebral salt wasting syndrome (CSWS) in cerebral injury

Objective- To review and analyze the diagnosis and treatment of cerebral salt wasting syndrome (CSWS) in cerebral injury. Methods- Clinical manifestations of 22 cases with CSWS patient were studied( ) retrospectively. The average age for those cases was (53.2±17.1) years. Mid-time of episode was 11 days and mid-course of the disease was 11 days. Results- All patients' symptoms coincided with diagnostic criterion of CSWS , including 8 severe cases whose blood serum Na were less than 120 mmol/L with a short time occurrence of disturbance of consciousness. For secondary severe and gently cases,the major clinical condition were symptom of digestive tract and awareness descending gradua1ly. By controlling water intaping, administering furosemide and albumin and supplying sodium, 4 severe cases resulted in death and the rest got recovery. Conclusion- CSWS is commonly seen in cerebral injury with an easy diagnosis,but the essential point in treatment is prevention and control of encephaledema.