颅脑损伤并发中枢性低钠血症的诊治体会

目的探讨中枢性低钠血症的诊断及处理方法。方法回顾性分析我院神经外科2001年1月-2008年11月收治的31例中枢性低钠血症患者的诊断及治疗方法。结果除3例患者因原发性脑干损伤在伤后5d内死亡外，其余患者的低钠血症均在3。15周内得到纠正。结论中枢性低钠血症包括脑性盐耗综合征（CSWS）和抗利尿激素分泌异常综合征（SIADH）两种类型，其临床表现相似，而处理原则相反。CSWS的治疗原则是以补盐、补水达到恢复血容量及维持钠的平衡为目的；SIADH的治疗原则是以限制水入量、降低血容量，使血钠恢复正常为目的。

The diagnosis and treatment of central hyponatremia after craniocerebral injury

Objective To explore the diagnosis and management of the central hyponatremia. Methods The clinical data of 31 patients with cenrtral hyponatremia, who received treatment in our hospital from January 2003 to November 2008, were analyzed retrospectively.Results Of the 31 patients with central hyponatrenfia,28 were cured within the 2 -8 weeks,3 died of the primary brainstem injury within 5 days after the injury. Conclusion The central hyponatremia includes cerebral salt wasting syndrome（CSWS） and syndrome of inappropriate secretion of antidiuretic hormone （SIADH）, which is similar to CSWS in the clinical manifestation and different from CSWS in treatment principle. The CSWS should be treated by complement salt and water to recover the blood volume and the equilibrium of the sodium,but SIADH should be treated by limiting intake of water to reduce the blood volume and make the blood sodium return normal.