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目的探讨ICU急性脑血管病合并高钠血症的发病原因、临床特点及与预后的关系。方法回顾分析我院ICU病房2011—2012年急性脑血管病症患者162例,所有患者均监测入院0,24,48,72h及此后每日一次的电解质血钠值,直至血钠值降至正常范围或患者出院或死亡,分析30例合并高钠血症患者发生率、病灶部位及与预后的关系,所有患者均进行APACHEⅡ评分并经过积极的病因治疗和对症治疗。结果共有30例患者纳入本研究,其中急性脑出血17例,急性脑梗死9例,脑外伤4例;其中男17例,女13例;平均年龄(58.12±18.33)岁;平均APACHEⅡ评分(24±7.9)分,平均血钠水平(156±10)mmol/L;死亡11例,病死率36.7%,死亡组的血钠水平、APACHEⅡ评分明显高于存活组。结论 ICU急性脑血管病发生高钠血症多发生在发病后3～8d,发生时间在7d左右的,血钠值与APACHEⅡ评分越高,预后越差,病死率也越高。
Objective To investigate the etiology, clinical features and prognosis of ICU with acute cerebral vascular disease complicated with hypernatremia. Methods A retrospective analysis of ICU ward in our hospital from 2011 to 2012, 162 cases of patients with acute cerebrovascular disease, all patients were monitored admission 0,24,48,72 h and after once a day of electrolyte sodium until serum sodium fell to the normal range Or patients were discharged or died. The incidence of 30 patients with hypernatremia, the location of the lesion and the relationship with the prognosis were analyzed. All patients underwent APACHEⅡscore and had positive etiological treatment and symptomatic treatment. Results A total of 30 patients were enrolled in this study. There were 17 cases of acute cerebral hemorrhage, 9 cases of acute cerebral infarction and 4 cases of traumatic brain injury. There were 17 males and 13 females, with an average age of 58.12 ± 18.33 years. The mean APACHEⅡ score (24 ± 7.9), average serum sodium level (156 ± 10) mmol / L; 11 died and the case fatality rate was 36.7%. The serum sodium level and APACHEⅡ score in the death group were significantly higher than those in the survival group. Conclusions The occurrence of hypernatremia in acute cerebrovascular disease of ICU mostly occurs 3 ~ 8 days after onset and occurs in about 7 days. The higher the serum sodium value and APACHE Ⅱ score, the worse the prognosis and the higher the mortality rate.