重型颅脑损伤后低血钠监测治疗研究.docVIP

重型颅脑损伤后低血钠监测治疗研究 　　[摘要] 目的：探讨颅脑损伤后并发低钠血症的病因、发病规律、监测及治疗。方法：回顾性分析1 116例颅脑损伤合并低钠血症患者的临床资料与治疗方法。结果：所有患者在伤后或术后前4 d出现低血钠例数较少，从第5天开始升高，第9天达到高峰。5～14 d为低钠期，从15 d后开始钠恢复正常，意识状态好转，以后无低钠血症发生。结论：颅底损伤颞底患者发生率高。以每天监测的血钠、血浆渗透压指导补钠更科学，血钠水平尽早恢复对患者恢复意识至关重要，是抢救重型颅脑损伤患者最重要的一环，是脑外科医师除手术外最重要影响预后的基本功。电解质紊乱关键在于早发现、早治疗，并不是不可战胜的疾病。 　　[关键词] 颅脑损伤；低血钠；监测；治疗 　　[中图分类号] R651.1+5 [文献标识码]A[文章编号]1674-4721（2011）03（b）-023-02 　　 　　Severe head injury after low serum sodium monitoring treatment research 　　WANG Jianrong 　　Department of Brain Surgery, the People′s Hospital of Xichang City, Sichuan Province, Xichang615000, China 　　[Abstract] Objective: To investigate craniocerebral injury after concurrent hyponatremia etiology, pathogenesis regularity, monitoring and treatment. Methods: All patients in after injury before or after four days appear low serum sodium per bed. It was less, from the first five days beginning to rise, the 9th day peak. 5-14 days for low sodium period, from 15 days start sodium return to normal and consciousness after improving, without hyponatremia happen. Results: After treatment 4-6 days urinary sodium gradually declined, serum sodium pick up gradually, 8-9 days of peak, 10 days for low sodium period, from 15 days start sodium return to normal and consciousness better. Conclusion: Skull base damage and temporal bottom patients high incidence. With daily monitoring blood sodium, plasma osmotic pressure sodium more scientific, guiding fill. Serum sodium leels early resumption of patient restore mind is vital, and severe head injury patients rescue is the most important one annulus, is the brain surgeon physicians outside the most important except surgery affect prognosis of basic skills. Electrolytes disturbance key lies in early detection and early treatment, and invincible disease. 　　[Key words] Craniocerebral injury; Low serum sodium; Monitoring; Treatment 　　 　　重型颅脑损伤患者的并发症较多，致残率及病死率高，是威胁人类健康的一大杀手，其中低血钠症最为常见[1]。现总结本院1997～2010年1 116例脑外伤并发低血钠症的患者资料，就低血钠症的发生原因、临床特点、治疗方法做一