慢性肺源性心脏病并发低渗性脑病临床分析

目的探讨慢性肺源性心脏病并发低渗性脑病的病因及防治方法。方法对37例出现神经精神症状的慢性肺源性心脏病患者，测定其血浆渗透压和血气分析，并根据测定结果进行有针对性的治疗。结果37例慢性肺源性心脏病患者血气分析排除了呼吸衰竭所致的肺性脑病，其血浆渗透压为206-259mmol／L，均明显降低，经补充电解质和综合治疗，35例（94．6％）恢复正常或接近正常，2例（5．4％）因并发多器官功能衰竭死亡。结论慢性肺源性心脏病患者出现神经精神症状时，不应只考虑肺性脑病、脑血管意外等疾病，应常规测电解质、血浆渗透压，了解是否合并低渗性脑病，以免误诊。一旦发现低渗性脑病，应立即补充电解质，综合治疗，以尽可能获得满意疗效。

Clinical analysis of chronic pulmonary heart disease complicated with hypotonic encephalopathy

Objective To explore the cause, prevention and therapy methods of the complication of hypotonie en- cephalopathy in chronic pulmonary heart disease. Methods Plasma osmotic pressure and blood gas analysis were applied in 37 patients with chronic pulmonary heart disease with neuropsychiatric symptoms. Results 37 patients were excluded pulmonary encephalopathy with blood gas analysis, whose plasma Osmotic pressure decreased significantly （206 259mmol/L）. 35 cases （94.6%） recovered after electrolyte supplement and comprehensive treatment. 2 cases （5.4%） died from multiple organ failure. Conclusions Plasma osmotic pressure and. electrolyte should be routinely detected when neuropsychiatric symptoms appeared in patients with chronic pulmonary heart disease.