脑疾病；低钠血症；脑性盐耗综合征；抗利尿激素分泌不当综合征

脑性盐耗综合征27例临床分析

http://www.100md.com 《东南国防医药》 2006年第5期

脑疾病；低钠血症；脑性盐耗综合征；抗利尿激素分泌不当综合征,,],脑疾病；低钠血症；脑性盐耗综合征；抗利尿激素分泌不当综合征,1临床资料,2结果,3讨论,参考文献

     [摘要] 目的探讨神经外科患者并发脑性盐耗综合征(CSWS)病因、发病机制、诊断及治疗方法。方法回顾性分析27例低钠血症患者的临床表现和实验室检查指标，明确诊断，确定有效的治疗方法。结果 22例患者低钠血症恢复，5例死于其他并发症。结论虽然CSWS发生机制尚不太明确，可能与神经对肾脏的传出障碍或利尿钠因子分泌紊乱有关。不同的是，SIADH需限制补液，而CSWS需补液、补钠。因此，两者的鉴别诊断至关重要。CVP测定和血浆ADH水平对鉴别诊断有重要意义。

    [关键词] 脑疾病；低钠血症；脑性盐耗综合征；抗利尿激素分泌不当综合征

    Clinical anaiysis of 27 cases with cerebral salt wasting syndrome

    ZHAN Huaiyi,YE Jianping,LI Ming (Department of Neurosurgery,the 81th Hospital of PLA,Nanjing 210002, Jiangsu, China)

    [Abstract] Objective To explore the pathogenesis mechanism,diagnosis and treatment of cerebral salt wasting syndrome (CSWS) in the neurosurgical patientsMethods Based on clinical manifestations and laboratory examination of 27 cases with hyponatremia that were retrospectively analyzed and the effective therapy was providedResults In this series,22 cases were cured and 5 cases died associated with other complicationsConclusion Although the exact mechanism of the development of CSWS has not been elucidated,the disruption of neural input into the kidney and/or central elaboration of circulation natriuretic factors are considered as the possible mecharismesUnlike SIADH requiring fluid restriction,CSWS requies fluid and sodium replacement.Thus,differential diagnosis between these two conditions is critical, CPV and the serum level of ADH are very important for the diffierential diagnosis ......

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