日间连续性肾替代治疗重症急性低钠血症

目的探讨日间连续性肾替代治疗（CRRT）重症急性低钠血症的有效性、安全性。方法对我院2005年1月～2010年12月的17例重症急性低钠血症住院患者使用金宝Prisma行连续性肾替代治疗（CVVH），每天治疗8h，连续3d，置换液使用前稀释，置换液流量4L／h，治疗前患者血清钠水平（112．5±4．0）mmol／L，第1天设定置换液钠浓度比血清钠水平高（10-14）mmol／L，第2、3天设定置换液治疗结束时钠浓度比实际血清钠水平高（9～12）mmol／L、（6～9）mmol／L。结果所有患者治疗时间3d，每天8h，均顺利完成，血清钠由治疗前（112．5±4．0）mmol／L上升到（140．2±2．8）mmol／L，血清渗透压逐渐恢复正常，神经精神症状明显好转，G1asgow评分由治疗前的（8．3±1．7）上升到（14．5±0．6）。结论CBP治疗急性严重低钠血症避免了传统方法使血清钠升得过快或过慢等缺点，能够按目标调整纠正血钠速度，本组研究表明CBP治疗急性严重低钠血症疗效确切，成功率高、安全，不失为急性重症低钠血症重要治疗手段。

Daytime continuous renal replacement therapy severe acute hyponatremia

Objective To explore the daytime continuous renal replacement therapy （CRRT） severe acute hyponatremia the efficacy, safety. Methods In our jan 2005 - 2010 December 17 cases of severe acute hyponatremia hospitalized patients use jinbao Prisma line continuous renal replacement therapy （CVVH）, daily therapy for eight hours, 3 consecutive days, replacement fluids before using dilution and displacement liquid flow 4L/h, patients serum sodium before treatment level 112.5 mmol/L, plus or minus 4. 0 day I set displacement liquid sodium concentrations than serum sodium high level 10 - 14 mmol/L, the first two or three days set d!splacernent liquid treatment end sodium concentrations than actual serum sodium high level 9 - 12mmol/L, 6 - 9 mmol/L. Results All patients time of 3 days, 8 hours a day, all successfully completed, serum sodium by before treatment 112. 5 mmol/L plus or minus 4. 0 rose to 140. 2 mmol/L, plus or minus 2.8 serum osmotic pressure return to normal gradually, neuropsychiatric symptoms improved obviously by before treatment, Glasgow score （8.3 ± 1.7 ）rise to 14. 5 plus or minus 0. 6. Conclusion CBP treatment of acute serious hyponatremia avoid the traditional methods make serum sodium rises too fast or slow shortcomings, can adjust blood sodium correct according to target speed, group study shows that CBP treatment of acute serious hy ponatremia definite effect, high success rate, safety, can yet he regarded as severe acute hyponatremia important therapy.