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目的探讨新生儿细菌性脑膜炎合并低钠血症的原因及干预方法。方法回顾性分析20例新生儿细菌性脑膜炎合并低钠血症的临床资料。结果患儿均表现为血钠下降,尿钠升高,血浆平均渗透压下降。其中12例有脱水、低血容量表现者,在综合治疗的基础上输液、补钠治疗;8例无脱水、低血容量表现者,予限制液体入量、限钠治疗。全部病例1～3d血钠恢复正常,治愈12例,好转6例,死亡2例。结论新生儿细菌性脑膜炎合并低钠血症系脑性耗盐综合征和抗利尿激素分泌异常综合征所致,治疗应具有针对性,早期纠正低钠血症在脑水肿的治疗中具有重要意义。
Objective To investigate the causes of neonatal bacterial meningitis complicated with hyponatremia and intervention methods. Methods The clinical data of 20 neonates with bacterial meningitis and hyponatremia were retrospectively analyzed. Results Children showed decreased serum sodium, elevated urinary sodium, plasma mean osmotic pressure decreased. Among them, 12 cases had dehydration and hypovolemia, and received infusion and sodium supplementation on the basis of comprehensive treatment. Eight patients with no dehydration and hypovolemia were limited in liquid intake and limited sodium treatment. All cases 1 ~ 3d serum sodium returned to normal, 12 cases were cured, 6 cases of improvement, 2 cases of death. Conclusions Neonatal bacterial meningitis with hyponatremia is caused by syndrome of cerebrovascular salt syndrome and syndrome of abnormal secretion of antidiuretic hormone. The treatment should be targeted and early correction of hyponatremia is important in the treatment of cerebral edema significance.