摘要
目的 探讨急性重型颅脑损伤后脑性盐耗综合征(CSWS)的临床特点、诊断和治疗方法。方法 回顾性分析49例急性重型颅脑损伤后CSWS患者的临床资料。结果 所有患者血清钠均低于130mmol/L,24h尿钠均大于80mmol/L,血浆渗透压小于270mos/L;36例患者血脑钠肽或脑钠肽前体增高。治疗6～22d后,46例患者血钠恢复正常,1例由于放弃治疗而死于低钠血症,2例死于肺部感染。结论 低血钠、高尿钠、低血容量、对补充血容量和补钠治疗有效是CSWS的临床特点及诊断依据;及时监测血钠水平并予补钠、补液治疗安全有效。
Objective To investigate the clinical features, diagnosis and treatment of cerebral salt wasting syndrome （CSWS） secondary to severe traumatic brain injury （STBI）. Methods The clinical data of 49 patients with CSWS secondary to STBI were analyzed retrospectively, including clinical manifestations laboratory findings and therapeutic method. Results In all the patients, the serum level of the sodium was less than 130 mmol/L, the urine sodium level in 24 h urine was more than 80 mmol/L, the plasma osmolality was less than 270 mos/L, and the serum level of brain natriuretic peptide （BNP） or BNP precursor increased in 36 patients before the treatment. After the treatment, the serum level of the sodium returned to normal in 46 patients, 1 patient died of hyponatremia due to abandoning treatment, and 2 patients died of the postoperative pulmonary infection. Conclusions The diagnosis of CSWS may be definitely made in the patients with STBI when they have hyponatremia, high level of urine sodium, and low blood volume, and supplying the fluid and sodium showed good curative effect on the patients. Timely monitoring the serum sodium and supplying the sodium and fluid are safe and effective treatment of patients with CSWS secondary to STBI.
出处
《中国临床神经外科杂志》
2013年第3期143-145,共3页
Chinese Journal of Clinical Neurosurgery
基金
湖北省卫生厅科研项目(JX4B42)
关键词
重型颅脑损伤
低钠血症
脑性盐耗综合征
诊断
治疗
Cerebral sah wasting syndrome
Severe traumatic brain injury
Diagnosis
Treatment
