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目的探讨脑出血所致低钠血症的临床特点、发病机制、诊断、治疗及预后的关系。方法对脑出血患者的血清钠进行监测,将发病后24h、24～72h、3～7d及1周后的血钠,尿比重、24h出入量进行对比,观察低钠血症与发病时间,出血部位,意识障碍的关系及预后的影响。结果 24h、24～72h、3～7d、1周后分别占5.2%,23.8%58.5%19.5%。其中脑耗盐综合征(CSWS)42例,抗利尿激素分泌不当综合征(SIADH)12例,其他20例。结论脑出血并发低钠血症在临床中并不少见,主要与CWS有关,也与SIADH及脱水、利尿所致排钠增加和摄入补足有关,应给予鉴别和相关治疗。
Objective To investigate the clinical features, pathogenesis, diagnosis, treatment and prognosis of cerebral hyponatremia-induced hyponatremia. Methods Serum sodium in patients with cerebral hemorrhage was monitored. Serum sodium, urinary specific gravity and the amount of 24 h after admission were compared at 24h, 24 ~ 72h, 3 ~ 7d and 1 week after onset. The incidences of hyponatremia, onset time, hemorrhage Location, disturbance of consciousness and prognosis. Results 24h, 24 ~ 72h, 3 ~ 7d, 1 week later accounted for 5.2%, 23.8% 58.5% 19.5%. Among them, 42 cases of brain wasting salt syndrome (CSWS), 12 cases of syndrome of inappropriate secretion of antidiuretic hormone (SIADH) and 20 cases of other syndromes. Conclusions Cerebral hemorrhage complicated with hyponatremia is not uncommon in clinical practice, mainly related to CWS. It is also related to SIADH, dehydration, increased sodium excretion caused by diuresis and uptake, and should be identified and related to treatment.