垂体后叶素致低钠血症临床探究.docVIP

垂体后叶素致低钠血症临床探究 　 作者：肖玲 郑小河 郑忠生 余文聘 陈潮钦 吴洁文 【关键词】 叶素 摘要：目的：探讨垂体后叶素治疗咯血时致低钠血症的特点及治疗。方法：114例咯血患者中使用垂体后叶素治疗39例（垂体后叶素治疗组），没有使用垂体后叶素治疗75例（非垂体后叶素组），后者必要时使用立其丁治疗。所有患者予立止血、安络血及维生素C治疗，并监测血电解质。止血治疗的同时保证每日摄钠8～10g，如出现中、重度低钠血症，每日补钠10～12g。结果：所有患者治疗前血钠正常。垂体后叶素组39例均为中量以上咯血，25例出现低钠血症，停垂体后叶素后血钠恢复正常。非垂体后叶素组包括10例中量以上咯血者和65例少量咯血者，无1例出现低钠血症，两组存在显著差异P＜0.001。结论：垂体后叶素治疗易致低钠血症，治疗的开始即应补钠及适当限制入水量，切忌在血钠过低后急剧地补钠，否则可导致渗透性脱髓鞘病变，表现为不可逆精神失常。 关键词: 咯血 垂体后叶素 立其丁 低钠血症 The Clinical Study of Hypophysin Leading to Hyponatremia Abstract: Objective: To evaluate the characteristic and treatment of hypophysin leading to hyponatremia. Method: There were 39 cases treating with hypophysin ( hypophysin group ) and 75 cases without using hypophysin (non-hypophysin group). In necessary time, the second group treated with pheotolamine. All cases treated with reptilase, adenogen and VitC, and monitored electrolytes. In the same time, all cases were supplied with 8～10g natrium everyday. If there was midrange or high hyponatremia, it would be important to supply with 10～12g natrium everyday.Result: The blood natrium of all cases were normal before treatment. 39 cases treating with hypophysin were medium or generous quantity hemoptysis, and 25 cases had hyponatremia. After stopping using hypophysin, the blood natrium was recovery. The non-hypophysin group included 10 cases of medium or generous quantity hemoptysis using phentolamine and 65 cases of a small quantity hemoptysis without using vasoactive agent. There was no hyponatremia in the second group. There was significant difference between two groups. Conclusion: It easy leaded to hyponatremia when treating with hypophysin. It was important to appropriately supply natrium and confine the entering capacity of water as time as hemostasis. It was danger to sharply supplied natrium when serious hyponatremia. Because what could induce permeability demyelinating disease. Then displayed mental disorder. Key words: Hemoptysis; Hypophysin; Phentolamine; Hyponatremia 咯血（