神经危重症患者高钠血症相关危险因素及预后分析

目的分析神经内科重症监护病房(NICU)高钠血症的发生率、临床特点、危险因素及预后情况。方法选取2011年9月~2012年6月首次入住我院NICU的200例神经危重症患者,记录患者的一般资料(年龄、性别)、主要诊断、卒中史(脑梗死、脑出血)、高血压、糖尿病、高钠血症形成的相关危险因素及患者的预后等情况,根据患者血钠水平给予分组。结果高钠血症组病死率明显高于非高钠血症组,随着血钠浓度的升高,患者的死亡率逐渐升高;甘露醇的大量使用、机械通气、肾功能不全分别高钠血症形成的独立危险因素。结论高钠血症形成的相关危险因素为大量甘露醇的使用、机械通气和肾功能不全;高钠血症是影响神经危重症患者预后的独立危险因素。

Relative risk factors and prognosis analysis of hypernatremia in critical patients with neurology disease

Objective To investigate the incidence ,clinical features ,risk factors and prognosis of the patients with hypernatremia in the neurological intensive care unit ( NICU) .Methods 200 cases in the NICU of The First Bethune Hos-pital of Jilin University from September 1st,2011 to June 1st,2012 were recruited.They were divided into two groups (hy-pernatremia and non-hypernatremia).Recording the basic information (included the age,gender,history of stroke,hyper-tension,diabetes).Results Hypernatremia mortality rate was significantly higher than the non-hypernatremia group.With the serum sodium concentration increased , the mortality rate of patients gradually increased .The use of large amounts of mannitol,mechanical ventilation and renal dysfunction were associated with hypernatremia (P<0.05).Conclusion The use of large amounts of mannitol ,mechanical ventilation and renal dysfunction are risk factors of the hypernatremia .Hhy-pernatremia is an independent risk factor affecting the prognosis of nerve in critically ill patients .