肝移植术后高钠血症的原因及治疗方法(附28例报告)

目的探讨肝移植术后高钠血症的原因及治疗方法。方法对28例肝移植术后高钠血症患者的临床资料进行回顾性分析。结果患者术前均无高钠血症；21例高钠血症发生在术后48h内；16例血钠为146～150mmol／L，9例为151～155mmol／L，3例为156～160mmol／L;有18例并发低钾血症，21例并发高磷血症，13例伴有肾脏损害。对不同程度的高钠血症，采用不同的治疗方法，严格计算补液量、补液内容以及补液速度。经治疗，24例患者完全康复，3例死亡，1例致残。结论肝移植术后发生高钠血症的原因是多方面的；治疗应在处理原发病的基础上适时、适量的补充液体，并选择好补液速度。

Cause and management of hypernatremia after liver transplantation

Objective To explore the cause and management of hypernatemia after liver trans plantation. Methods The clinical data of 28 patients with hypernatremia after liver transplantation were analyzed retrospectively. Results Among the patients, no hypernatremia occurred before operation and postoperative hypernatremia occurred in 21 cases within 48 h. Blood natrium varied from 145 to 150 mmol/L in 16 cases, 151 to 155 mmol/L in 9 cases, and more than 156 mmol/L in 3 cases. The levels of blood potassium and phosphor were all within normal range. Hypnatremia was treated by supply of water via gastrointestine and/or by veins. Conclusions Various causes could result in hypernatremia after liver transplantation. The hypernatremia was treated by supply of water gradually.