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重症肺炎合并低钠血症,因后者的症状易被原发病的症状所掩盖而被漏诊。本院近10年共收治重症肺炎324例,合并低钠血症23例(占7.1％).现分析如下。 临床资料(1)年龄与性别:1-3月5例。-6月6例.-9月7例,-12月5例,男:女一15:8。(2)诊断标准:重症肺炎诊断按卫生部的小儿肺炎防治方案。低钠血症按血Na~+<130mmol/L为标准。(3)临床表现:症状出现时间:低钠血症症状在肺炎发病后5天内出现者3例,5-10天出现7例,10天后出现13例。精神萎糜、表情淡漠20例,厌食、呕吐19例,腹胀5例,嗜睡10例,腱反射消失、肌张力低下6例,昏迷4例,抽搐9例,呼衰4例.心衰22例。(4)血钠浓度与预后:血钠浓度121-130mmol/L者15例.死亡l例;111-120mmol/L者6例,死亡4例;100-110mmol/L者2例均死亡。死亡率为7/23例(30.4％)。(5)伴发疾病:伴发低钾血症6例.低钙血症4例,营养不良8例.佝偻病5例,贫血9例。肠炎6例。
Severe pneumonia with hyponatremia, because the latter’s symptoms are easily covered by the symptoms of the primary disease was missed. The hospital in the past 10 years were treated 324 cases of severe pneumonia, hyponatremia in 23 cases (7.1%). Now analyzed as follows. Clinical data (1) age and gender: 1-5 cases in January-March. - 6 cases in June - 7 cases in September, - 5 cases in December, male: female 15: 8. (2) diagnostic criteria: diagnosis of severe pneumonia according to the Ministry of Health’s pneumonia prevention and control programs. Hyponatremia by blood Na ~ + <130mmol / L as the standard. (3) clinical manifestations: symptoms appear time: symptoms of hyponatremia in 5 days after the onset of pneumonia in 3 cases, 5-10 days appeared in 7 cases, 10 days after the emergence of 13 cases. Mental exhaustion, apathy 20 cases, anorexia, vomiting in 19 cases, abdominal distension in 5 cases, lethargy in 10 cases, tendon reflex disappeared, hypotonia in 6 cases, coma in 4 cases, convulsions in 9 cases, respiratory failure in 4. 22 cases of heart failure . (4) Serum sodium concentration and prognosis: Serum sodium concentration 121-130mmol / L in 15 cases, 1 case of death, 111-120mmol / L in 6 cases, 4 cases of death, 100-110mmol / L in 2 cases were killed. The mortality rate was 7/23 (30.4%). (5) with disease: associated with hypokalemia in 6 cases .Hypocalcemia in 4 cases, malnutrition in 8. Rickets in 5 cases, 9 cases of anemia. Enteritis in 6 cases.