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本文回顾分析了我院 ICU 发生高血钠症的50例患者的临床及辅助检查资料,并探讨高血钠发生的危险因素,以有效预防高血钠并发症。1 资料与方法1.1 一般资料男32例,女18例,年龄6～78岁,平均40岁,脑外伤30例,脑出血4例,感染性休克16例。1.2 方法患者入 ICU 即时测定血清钠,同时完善血、尿常规和肝、肾功能检查,此后每日必测血清钠,并根据病情监测血钠浓度。血清钠采用全自动离子分析仪测定,同时观察24 h 出入液体量、患者意识变化、是否经口饮水受限、是否发热、经胃肠引流液体的量、利尿脱水剂的使用及血糖;昏迷病人前3 d 不进食,3d 后改为鼻饲,清醒病人尽早进食。高血钠的诊断按《内科学》中血钠≥148 mmol/L 作为高血钠症的标准。
This paper retrospectively analyzed the clinical and auxiliary examination data of 50 patients with hypernatremia in ICU of our hospital and explored the risk factors of hypernatremia in order to effectively prevent the complications of hypernatremia. 1 Materials and Methods 1.1 General Information 32 males and 18 females, aged 6 to 78 years, mean 40 years, 30 cases of traumatic brain injury, cerebral hemorrhage in 4 cases, septic shock in 16 cases. 1.2 Methods Patients into the ICU real-time determination of serum sodium, while improving blood, urine and liver and kidney function tests, since then will be measured daily serum sodium, and serum sodium concentration monitoring. Serum sodium was measured by automatic ion analyzer. At the same time, the amount of liquid excreted in and out of the patients at 24 hours was observed. The patient’s consciousness was changed, whether oral drinking water was limited, fever, the amount of liquid transfused through gastrointestinal tract, the use of diuretic dehydrating agent and blood glucose; The first 3 d did not eat, after 3d into nasal feeding, awake patients eat as soon as possible. The diagnosis of hypernatremia by “internal medicine” in the blood sodium ≥ 148 mmol / L as a standard hyponatremia.