神经外科患者术后低钠血症诊断及治疗

目的:探讨神经外科患者术后低钠血症的常见病因、发病机理、鉴别诊断和治疗方法。方法:回顾性分析180例神经外科术后低钠血症患者的临床表现、实验室检查结果,根据病因分为4种类型并分别采用不同的治疗方法。结果:180例低钠血症患者中营养性或利尿性低钠血症70例,脑性盐耗综合征57例,抗利尿激素分泌异常综合征35例,尿崩症18例。所有患者的低钠血症均得到纠正,取得良好效果。结论:营养性和利尿性低钠血症给予补钠即可,脑性盐耗综合征患者需要补充钠盐,同时补足血容量,抗利尿激素分泌不当综合征患者则需要限水治疗。尿崩症患者应用激素替代治疗。

Diagnosis and management of hyponatremia in neurosurgical patient

Objective To discuss the etiological factor,etiopathogenesis,differential diagnosis and management principles of various types of hyponatremia in neurosurgical patient.Methods Clinical data of 180 cases of hyponatremia were analyzed retrospectively.According to etiological factor,all patients were treated corresponding to their differential diagnosis.Results In 180 patients,hyponatremia occurred due to inadequate supplement and diuretic in 70 cases,cerebral salt wasting syndrome in 57 cases,syndrome of inappropriate secretion of the antiduretic hormone in 35 cases,and diabetes insipidus in 18 cases.All patients had gotten good prognosis.Conclusion Hyponatremia due to inadequate sodium or diuretic is subject to the supplementation of sodium in treatment,cerebral salt wasting syndrome to not only sodium but also blood volume supplementation,syndrome of inappropriate secretion of the antiduretic hormone to limiting of water intake,diabetes insipidus to the infusion of antidiuretic hormone.