重症中枢神经系统感染患儿内环境紊乱的临床分析

目的 探讨重症中枢神经系统感染（CNSI），患儿应激性高血糖（SHG）和电解质紊乱与病情发展的关系，并探讨重症CNSI患儿血糖及血钾、钠、钙、镁的变化及其相互关系。方法 对2000年5月至2003年6月住院的46例重症CNSI患儿进行血糖及血钾、钠、钙、镁动态监测，并以32例轻症CNSI患儿为对照组进行比较。结果 重症CNSI患儿易发生SHG、低钠血症（HN）、低钾血症（HK）、低钙血症（HC）、低镁血症（HK）。血糖的升高,血钠、血钾、血钙的降低与CNSI患儿病情轻重关系密切，随病情好转，上述指标逐渐恢复正常。结论 重症CNSI患儿存在应激损伤，机体的过度应激反应也可引起血清电解质的改变，由此加重内环境的紊乱，故控制应激反应,稳定内环境十分重要。

A clinical analysis for internal environment unbalance of children with serious infection of central system

Objective To explore the association between stress hyperglycemia and internal environment unbalance in children with the serious infection of central system,and to explore the changes between blood sugar,blood potassium,blood sodium,blood calcium and blood magnesium and the relationship between them.Methods Stool samples were collected from 46 hospitalized children with serious infection of central nervous system between May 1,2000 and June 30,2003.These samples are used to monitor the blood sugar,blood potassium,blood sodium,blood calcium and blood magnesium,and comparing with the control group of 32 hospitalized children with mild infection of central nervous system.Results Children with the serious infection of central nervous system have more psychological problems with hyponatremia,hyporalemia,hypocalcemia and hypomagnesemia.Children's conditions are closely related with hyperglycemia,hyporalemia,hyponatremia and hypocalcemia.When the conditions turn to be better,the indications above gradually become normal.Conclusion Stress injuries take place in children with serious infections of central nervous system.The over-reactions can lead to the changes of electrolytes and thus worsen the internal homeostasis.So it is important to maintain homeostasis and to take the stress reaction under control.