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低渗性脑病作为肝硬化肝外损害的一部分,近年日益引起重视。但由于其临床症状复杂多样,有时难以早期诊断,作者结合诊治的28例病人作一回顾性分析。1 临床资料 本组28例均为我院1994年4月至1999年5月在内科和传染科住院的病人,其中男21例,女7例;年龄22—56岁,平均35.7岁。28例中肝炎后肝硬化23例,血吸虫性肝硬化5例。 病人在治疗原发病过程中均有长期/大量应用利尿剂或脱水剂以及限钠限水史,主要表现为治疗过程中出现以下症状:头痛、头晕、恶心、无力(17例),感觉迟钝(15例),谵妄、嗜睡、昏迷(5例)。全部病人在入院时均进行血生化检查,血清钠为132～141mmol/L,血浆渗透压为281～305mOsm,当出现低渗性脑病时复查血清钠为112—129mmol/L,复查血浆渗透压为255～277mOsm,所有病人诊断均符合低渗性脑病诊断标准。
Hypotonic encephalopathy as part of extrahepatic lesions of cirrhosis in recent years has drawn increasing attention. However, due to its complex and diverse clinical symptoms, and sometimes difficult to early diagnosis, combined with the diagnosis and treatment of 28 patients for a retrospective analysis. 1 Clinical data The group of 28 patients were hospitalized in our hospital from April 1994 to May 1999 in the Department of Internal Medicine and Infectious Diseases, including 21 males and 7 females; aged 22-56 years, mean 35.7 years. Twenty-eight patients had posthepatitis cirrhosis (23 cases) and schistosomiasis cirrhosis (5 cases). Patients in the treatment of primary disease have long-term / large number of diuretics or dehydrating agent and sodium limit of water restriction, mainly for the treatment of the following symptoms: headache, dizziness, nausea, weakness (17 cases), feeling insensitive (15 cases), delirium, drowsiness and coma (5 cases). All patients were on admission biochemical tests were performed, serum sodium was 132 ~ 141mmol / L, plasma osmolality of 281 ~ 305mOsm, when hypotonic encephalopathy review of serum sodium 112-129mmol / L, the review of the plasma osmolality 255 ~ 277mOsm, all patients diagnosed with hypotonic encephalopathy diagnostic criteria.