Hypernatremia on the diagnosis and treatment.docVIP

 PAGE \* MERGEFORMAT 8 Hypernatremia on the diagnosis and treatment [Keywords:] diagnosis and treatment of hypernatremia A clinical 1. The prominent symptoms of early Thirst is a prominent early symptoms of the disease is clinically important intracellular water loss mark. Urine output decreased, pulse rate and blood pressure changes less. Severe eye depression, nausea, vomiting, fever, and the baby can be high fever, muscle weakness, abnormal EMG, peripheral circulatory failure may occur late. 2. Neuropsychiatric symptoms High-sodium hypertonic state of the main symptoms are neuropsychiatric symptoms. An early manifestation of lethargy, weakness and irritability, occur gradually as irritability, tremors, clumsiness, tendon hyperreflexia, increased muscle tone, there may be further development of seizures, convulsions , coma and death. serum sodium more than 158mmol / L, the higher rate of% seizures, severe cases can cause irreversible nerve damage. Second diagnosis Can be learned from the history of water or excessive water loss, or a history of excessive sodium intake, combined with thirst, dryness of oral mucosa, decreased urine output, urine osmolality (Uosm) and higher relative density of urine or past polyuria and decreased urine output now can quickly make a clinical diagnosis. but of consciousness or unconscious patients, if you can not get the exact history, and sometimes cause diagnostic difficulties. Therefore, taking into account various causes the identification of hypertonic syndrome and their relationship. In this case, serum sodium and Uosm, Bosm determine the diagnosis. (1) the diagnosis of hypernatremia can refer to the following criteria: ① sustained hypernatremia, ② no obvious signs of dehydration; ③ body still ADH secretion, ④ tubular ADH still reactive. (2) the magnitude of increase in serum sodium hyperosmolar state and extent of the judge is an important indicator. Serum Na +gt; 150mmol / L