摘要
目的探讨结核性脑膜脑炎合并低钠血症的临床表现和实验室检查的特点,分析对症治疗后的效果,降低并发症的发生。方法回顾性分析2011年2月-2013年1月142例结核性脑膜脑炎患者临床资料,对其中的55例低钠血症患者的临床表现和实验室检查进行分析,并观察治疗后的效果。结果结核性脑膜脑炎合并轻中度低钠血症患者的临床表现以精神不振、反应性差和疲惫乏力为主,而重度患者则以头痛、剧烈呕吐、血压降低为主,临床表现发生率均达100.0%;轻中度和重度之间在血钠的浓度、血浆渗透压、尿素氮和中心静脉压除钠的浓度升高外,其他的均下降;经过积极治疗后轻、中、重度低钠血症患者临床症状改善。结论结核性脑膜脑炎合并低钠血症要先寻找病因,根据病因和临床表现等综合分析后进行对症治疗才能改善症状,提高血钠水平。
OBJECTIVE To study the clinical manifestations and characteristics of laboratory tests of tuberculousmeningoencephalitis combined with hyponatremia, analyze the effect after symptomatic treatment,so as to reducethe occurrence of complications. METHODS A retrospective analysis of the clinical data of 142 patients of tubercu-lous meningoencephalitis enrolled from Feb 2011 to Jan 2013 was performed. The clinical manifestations and laboratory tests of 55 patients with hyponatremia were analyzed and the treatment effect was observed. RESULTS Theclinical manifestations of patients with tuberculous meningoencephalitis combined with mild-to-moderate hyponatremia were mainly depression, poor reactivity and weakness; while the clinical manifestations of severe patients were mainly headache,severe vomiting, decreased blood pressure, with the occurrence of clinical manifestation as high as 100. 0%. Except for the increased sodium concentration, the serum sodium concentration, plasmaosmotic pressure,BUN and central venous pressure of the mild-to-moderate patients were lower than those of thesevere patients; after active treatment, the clinical symptoms of the mild,moderate and severe hyponatremia pa-tients were improved. CONCLUSION It is necessary to find out the causes of tuberculous meningoencephalitis combined with hyponatremia, carry out symptomatic treatment according to the tiology and clinical manifestations toimprove the symptoms and enhance the level of serum sodium.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第17期4200-4202,共3页
Chinese Journal of Nosocomiology
基金
天津市卫生局科技基金项目(2012KY12)
关键词
结核性脑膜脑炎
低钠血症
临床特点
临床效果
Tuberculous meningoencephalitis； Hyponatremia； Clinical characteristic ； Clinical effect
