摘要
目的探讨原发性蛛网膜下腔出血(SAH)急性期低钠血症(HN)的原因、发生情况、干预方法及其对预后的影响。方法首次发病的急性期SAH病人190例,测定血清钠,对发生HN患者分析其病因并给予不同的处理。结果SAH后HN占同期原发性SAH的45.3%;并发HN者死亡率、脑血管痉挛(CVS)和继发性脑梗死、脑积水的发生率均显著高于血钠正常者(P<0.05);本组总死亡率为17.8%,低于文献报道。结论SAH后HN发生率很高;是预后差的危险因素;且与CVS、脑积水关系密切;其原因为脑性盐耗竭综合征和抗利尿激素分泌失调综合征,应针对病因治疗。
Objective To investigate the cause,occurrence,treatments and its effects on patient~'s outcome of hyponatremia caused by primary subarachnoid hemorrage(SAH) during acute period.Methods Serum sodium density were measured on 190 patients with first SAH in acute period.The patients with HN were treated respectively according to their pathogenies.Results Hyponatremia after SAH was 45.3% of subarachoid hemorrage at the same period.The motality rate in the patients with hyponatremia were statistically higher than that in patients without hyponatremia(P<0.05).The percentage of secondary cerebral infarct,vasospasm and hydrocephalus were also higher in patients with hyponatremia than normal natremia(P<0.05).The total mortality was 17.8% and lower other's report.Conclusion The incidence of hyponatremia after SAH is very high.Hyponatremia may be the risk factor in poor outcome,and signicantly associated with symptomatic cerebrovascular spasm and hydrocephalus.The reasons are cerebral salt wasting syndrome and syndrome of inappropriate antidiuretic hormone secretion,the main measure is according to their pathogenisis respectively.
出处
《中国实用神经疾病杂志》
2006年第4期29-31,共3页
Chinese Journal of Practical Nervous Diseases
