高钠血症影响重型颅脑损伤预后的临床分析及处理

目的分析并探讨高钠血症对重型颅脑损伤患者预后产生的影响及处理对策。方法对我院自2007年11月至2010年10月期间收治的78例重型颅脑损伤后伴高钠血症患者的临床资料做回顾性分析。78例患者按血清钠水平分为高血钠组及高血钠组。结果全部78例重型颅脑损伤患者中继发高钠血症者37例,发生高钠血症组的GCS评分为3～5分者30例,GCS评分为6～8分者7例,两组相比差异显著（P〈0.01）,具有统计学意义。高钠血症患者有27例死亡,10例生存,两组的病死率相比,差异亦显著（P〈0.01）,具有统计学意义。结论患者高钠血症的病情程度和GCS分值具有密切的相关性。对于高钠血症,临床工作中必须充分提高预防意识,重视其严重后果尽早采取纠正高钠血症措施,在保守治疗无效的情况下,应尽早开始血液净化治疗,改善患者的预后。

Hypernatremia Influences the Prognosis in Severe Head Injury: Clinical Analysis and Treatment

Objective To analyze and explore the effect of hypernatremia on prognosis in patients with severe craniocerebral injury and countermeasures.Methods The clinical data of patients with severe craniocerebral injury and hypernatremia in our hospital from November 2007 to October 2010 were retrospectively analyzed.78 patients were divided into the hypernatremia group and non-hypernatremia group according to the serum sodium concentrations.Results Among 78 cases of severe craniocerebral injury,37 patients had secondary hypernatremia.The GCS score in hypernatremia group showed 30 cases of 3 ~ 5 scores,7 cases of 6 ~ 8 scores;the difference of GCS score between two groups was statistically significant（P 0.01）.27 cases died in hypernatremia group;the difference of mortality rate between two groups was statistically significant（P 0.01）.Conclusions Hypernatremia severity is closely related to GCS values.For hypernatremia,we should improve the prevention awareness fully,take attention to the serious consequences and take measures to correct hypernatremia as early as possible.Blood purification therapy should be performed as early as possible to improve the patients＇ prognosis when conservative treatment fails.