肝硬变腹水患者的低钠血症

［ 背景］ 肝硬化腹水患者的低钠血症较常见， 但疏于诊治．［ 病例报告］ 对１２８ 例肝硬变腹水患者中合并低血钠的８３ 例（６５ ％ ） 进行分析．其中肝功能Ｃｈｉｌｄ Ｐｕｇｈ Ａ 级４４ 例，血钠（１３１－８ ±１－７）ｍ ｍｏｌ／Ｌ；Ｂ级３０ 例，血钠（１２４－７ ±２－９）ｍ ｍｏｌ／Ｌ；Ｃ级９ 例，血钠（１１６－９ ±３－８）ｍ ｍｏｌ／Ｌ．血钠在１３１ ～１３４ｍ ｍｏｌ／Ｌ 之间有３２ 例，死亡２ 例（６ ％ ） ；在１２６ ～１３０ｍ ｍｏｌ／Ｌ 之间有２４ 例，死亡４ 例（１７ ％ ） ；低于１２５ｍ ｍｏｌ／Ｌ２３ 例，死亡８ 例（３２ ％ ） ．［ 讨论］ 血钠浓度在一定程度上可反映肝硬变腹水患者肝功能代偿情况，低血钠与预后有一定关系，血钠程度与死亡率之间存在明显相关性．对肝硬变腹水患者进行综合治疗过程中应密切地监测血钠的变化，及时纠正低血钠，以改善预后

Hyponatremia of patients with cirrhosis ascites

BACKGROUND Hyponatremia of patients with cirrhosis ascites are rather common in clinical, but neglect to make a diagnosis and treatment.CASE REPORT 83 cases(65%) of hyponatremia among the 128 patients with cirrhosis ascites were investigated. The degree of liver function Child Pugh A were 44 cases, natremia (131 8±1 7)mmol/L; Child Pugh B were 30 cases, natremia (124 7±2 9) mmol/L; Child Pugh C were 9 cases , natremia (116 9±3 8)mmol/L. Natremia range between 131～134mmol/L were 32 cases, two cases died(6%); range betweem 126～130mmo/L were 20 cases , four cases died(17%); lower than 125mmol/L were 23 cases, 8 cases died(32%).DISCUSSION The consistency of natremia can reflect liver function repair condition of the patients with cirrhosis ascites in certain degree.There is relationship between hyponatremia and prognosis, between natremia level and the mortality . In the treatment of the patients with cirrhosis ascites it should be done to determine the natremia changes,and to correct hyponatremia promptly to improve the progress.