中枢性低钠血症的诊治体会

目的探讨中枢性低钠血症的发病机制、诊断及治疗方法。方法对该院21例中枢性低钠血症患者的临床资料进行回顾性分析。结果19例低钠血症恢复正常；2例因合并颅内感染，高热不退，1例死亡，1例经控制感染后，低钠血症恢复正常，但仍昏迷不醒。结论低血钠、高尿钠和意识状态改变是中枢性低钠血症的诊断依据，抗利尿激素分泌不当综合征（SIADH）应限水治疗，脑性盐耗综合征（CSWS）则作水化和补盐治疗。

Experience of diagnosis and treatment of the central hyponatremia

Objective To investigate the pathogenesis and the methods of diagnosis and treatment of central hyponatremia. Methods The clinical data of 21 patients with central hyponatremia were retrospectively analyzed. Re- sults After treatment, serum sodium return to normal level in 19 cases of hyponatremia; 2 eases had unabating high fever due to intracranial infection, of them 1 ease died, 1 case had normal serum sodium level, hut still in a coma af- ter infection being controlled. Conclusion Low serum sodium, high urine sodium and change of consciousness stateis the diagnostic basis of central hyponatremia, syndrome of inappropriate secretion of antidiuretic hormone（SIADH） patients should receive limiting water treatment, cerebral salt wasting syndrome（CSWS） patients should receive water and salt treatment.