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目的总结上消化道大出血患者应用脑垂体后叶素致严重低钠血症的临床经验。方法收集湖北省部州市中心医院消化内科1999年6月至2004年12月收治的2460例上消化道大出血应用脑垂体后叶素治疗的患者的病例资料,观察消化道症状及神经、精神等全身症状及动态监测血钠监测结果。结果其中30例发生严重低钠血症,发生率为1.22%。血清钠<110 mmol/L。临床表现为恶心、呕吐、昏睡、昏迷、抽搐等。治疗采取补充高浓度钠,停用垂体后叶素,含盐饮食,动态监测血清钠浓度。所有患者均在治疗后1～3 d 好转,无一例死亡。结论上消化道大出血患者应用脑垂体后叶素治疗过程中易出现严重低钠血症,应严密观察患者临床表现,及时监测血钠,一旦发生低钠血症及时治疗。
Objective To summarize the clinical experience of severe hyponatremia induced by pituitrin in patients with upper gastrointestinal hemorrhage. Methods A total of 2460 cases of upper gastrointestinal bleeding treated with pituitrin were collected from Department of Gastroenterology, Department of Gastroenterology, Department of Gastroenterology, State Hospital of Minzhou, Hubei Province from June 1999 to December 2004. The gastrointestinal symptoms, nerves and spirits were observed Systemic symptoms and dynamic monitoring of serum sodium monitoring results. Results of 30 cases of severe hyponatremia, the incidence was 1.22%. Serum sodium <110 mmol / L. Clinical manifestations of nausea, vomiting, lethargy, coma, convulsions and so on. Treatment to take high concentrations of sodium supplements, pituitrin disabled, pituitary, salt diet, dynamic monitoring of serum sodium concentration. All patients improved 1 to 3 days after treatment without any death. Conclusion Severe hyponatremia is prone to occur in the treatment of patients with upper gastrointestinal hemorrhage due to pituitrin. The clinical manifestation should be closely observed and serum sodium should be monitored in time. Once hyponatremia is treated promptly,