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目的:探讨颅脑损伤并发中枢性低钠血症的病因、发病机制、诊断及治疗方法。方法:对我院2000年1月~2008年6月收治的84例颅脑损伤并发中枢性低钠血症临床资料进行回顾性分析。结果:本组有抗利尿激素异常分泌综合征(SIADH)24例,脑性盐耗综合征(CSW S)60例,血钠均<130 mmol/L,最低107 mmol/L,血浆渗透压<270 mOsm/L,尿钠均>80 mmol/24h。中心静脉压<6 cmH2O 60例,>12 cmH2O 24例。除15例因重度颅脑损伤死于脑功能衰竭外,其余患者低钠血症均得以纠正,治愈时间为2~4周。结论:对颅脑损伤患者应密切监测血钠浓度,SIADH和CSW S发病机制与治疗措施不同,及时正确地诊治可改善预后,降低病死率。
Objective: To explore the etiology, pathogenesis, diagnosis and treatment of central hyponatremia complicated by brain injury. Methods: The clinical data of 84 patients with craniocerebral injury complicated with central hyponatremia admitted to our hospital from January 2000 to June 2008 were retrospectively analyzed. Results: There were 24 cases of SIADH and 60 cases of CSWS, the serum sodium were all less than 130 mmol / L, the lowest was 107 mmol / L, the plasma osmolality was < 270 mOsm / L, urine sodium> 80 mmol / 24h. Central venous pressure <6 cmH2O 60 cases,> 12 cmH2O 24 cases. Except for 15 cases died of brain failure due to severe craniocerebral injury, other patients were corrected for hyponatremia, the healing time was 2 to 4 weeks. Conclusion: Serum sodium levels should be closely monitored in patients with craniocerebral injury. The pathogenesis and treatment of SIADH and CSW S are different. Timely and correct diagnosis and treatment can improve prognosis and reduce mortality.