重型颅脑损伤后中枢性低钠血症的诊断及治疗

目的探讨重型颅脑损伤患者并发中枢性低钠血症的病因、诊断及治疗。方法回顾性分析重型颅脑损伤后发生中枢性低钠血症患者42例的临床表现及实验室指标，分析其治疗方法。结果发生中枢性低钠的42例患者中，11例诊断为抗利尿激素分泌失调综合征（SIADH），31例诊断为脑性盐耗综合征（CSWS）。经过针对性治疗，除1例患者放弃治疗，最终在家死于低钠血症外，其他41例患者经过治疗，低钠血症均治愈。结论SIADH和CSWS的发病机制及治疗措施不同，对其进行正确诊断并进行针对性的治疗才能纠正中枢性低钠血症。

Diagnosis and treatment of central hyponatremia after serious craniocerebral injury

Objective To discuss the causes,diagnosis and treatment of hyponatremia in serious craniocerebral injury patients. Methods Forty-two patients with central hyponatremia after serious craniocerebral injury were retrospectively ana- lyzed on clinical manifestation,laboratory examination and therapeutic course. Results 11 cases were diagnosed syndrome of inappropriate antidiuretic hormone secretion （SIADH）, and 31 cases were diagnosed cerebral salt wasting syndrome （CSWS）. Af- ter specific treatment, except for one patient to give up treatment and ultimately died of hyponatremia at home, the other 41 pa- tients were cured after treatment. Conclusion As the pathogenesis and treatment measures are different, correct diagnosis and specific treatment measures are the base of the treatment of central hyponatremia.