重度颅脑损伤后钠代谢紊乱临床分析

目的探讨钠代谢紊乱发生的原因、预后及其治疗方法。方法选取276例重度颅脑损伤患者的临床资料。患者均在伤后1d，入院后第3天及1周后行血清钠检测。对低钠血症患者同时测定尿钠、中心静脉压。结果低钠血症的患者易被纠正，而高钠血症患者脑损伤严重程度与血钠水平及预后关系密切。高血钠组与非高血钠组病死率比较，差异有统计学意义（P〈0．01）。结论根据不同的病因采取相应的治疗方案是治疗颅脑损伤后钠代谢紊乱的关键。同时积极治疗其他并发症，如高血糖、低血压等，以降低继发性脑损伤，降低病死率。

Clinical analysis of natrium metabolic disorder following severe craniocerebral injury

Objective To investigate the cause, prognosis and therapeutics of natrium metabolic disorder in serious craniocerebral injury.Methods 276 patients with serious craniocerebral injury were selected for analysis.Serum natrium levels in the first day, third day and 1 week following injury were detected. Serum and urine natrium in hyponatremia patients were measured.Results Hyponatremia was easy to be rectified, the degree of craniocerebral injury had colse relationship with the serum levels of natrium and prognosis in patients with hypernatremia.Mortality had a significant difference between the groups of hyponatremia and hypernatremia(P<0.01).Conclusion The key point of the treatment for metabolic disorder following craniocerebral injury is to identify the cause of natrium metabolic disorder.Active treatment should be taken for other complications such as hyperglycaemia and hypotension, in order to cut down secondary brain injury and lower mortality rate.