老年颅脑损伤并发低钠血症病人的临床观察与护理

目的 探讨老年颅脑损伤并发低钠血症病人的观察与护理方法.方法 对71例老年颅脑损伤并发低钠血症病人严密观察意识变化,密切监测尿量及血、尿生化指标等,判定引起低钠血症的原因;早期干预饮食以利纠正低钠血症,并精心护理.结果 诊断为营养性低钠血症59例,经对症处理后血钠基本恢复正常;诊断为抗利尿激素不当分泌综合征(SIADH)3例,脑性盐耗综合征(CSWS)9例,根据不同治疗原则处理后,低钠血症均得到不同程度的纠正.本组存活65例,因原发病或其他合并症过重死亡6例.结论 对老年颅脑损伤并发低钠血症病人进行严密的病情观察与精心护理,可提高治愈率.

Clinical observation and nursing of the hyponatremia patients after craniocerebral injury in the elderly

Objective To explore the methods for clinical observation and nursing of the hyponatremia patients after craniocerebral injury in elderly. Methods Seventy one elderly patients with craniocerebral injury complicated by hyponatremia were observed for changes in consciousness and assayed for urine volume and plasma and urine biochemical variables to diagnose the cause of hyponatremia. Early intervention of diet was administered to correct hyponatremia and careful nursing given simultaneously. Results Fifty nine patients with nutritional hyponatremia were basically recovered after expectant treatment. Three patients with syndrome of inappropriate secretion of the antidiuretic hormone （SIADH） and 9 cerebral salt-wasting syndrome （CSWS） were treated according to different therapeutic principles and hyponatremia was corrected to different degree. Sixty five out of 71 patients survived and the other 6 patients died of severe primary diseases or complications. Conclusion Close observation and careful nursing could improve the success rate and promote early recovery of hyponatremia patients after craniocerebral injury in the elderly.