重型颅脑损伤后中枢性低钠血症临床观察及治疗

目的探讨重型颅脑损伤后中枢性低钠血症的治疗方法及临床疗效。方法选取本院26例重型颅脑损伤后中枢性低钠血症的患者为研究对象,根据其临床特点及检查结果分为抗利尿激素分泌不当综合征（SIADH）5例和脑性盐耗综合征（CSWS）21例,给予相应的治疗,总结两组的治疗效果。结果 CSWS组的中心静脉压（CVP）、抗利尿激素（ADH）显著低于SIADH组,CSWS组血浆心钠素（ANP）值显著高于SIADH组,P〈0.05。26例患者中,有2例患者死亡,24例患者低钠血症得到纠正。结论 SIADH和CSWS是引起重型颅脑损伤后中枢性低钠血症的主要原因,应针对不同的病因采取有针对性的治疗,降低病死率。

The treatment methods and effect observation in central hyponatremia after Severe traumatic brain injury

Objective To investigate the treatment methods and its effect in central hyponatremia after severe traumatic brain injury. Methods Twenty six cases of central hyponatremia after severe traumatic brain injury patients were chosen as the research object, they were examined for the syndrome of inappropriate secretion of antidiuretic hormone （SIADH） in 5 cases with cerebral salt wasting syndrome （CSWS） in 21 cases according to their clinical characteristics and outcomes, for the corresponding treatment, summarizes two group treatment effect. Results The central venous pressure （CVP）, antidiuretic hormone （ADH） in group CSWS were significantly lower than SIADH group, plasma atrial natriuretic peptide （ANP） in group CSWS was significantly higher than that in group SIADH, P 0.05. 2 cases in 26 patients died, 24 cases of patients with hyponatremia were corrected. Conclusion SIADH and CSWS are caused by severe head injury hyponatremia after main reason, it should be aimed at different etiology of targeted therapy to mortality rate.