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中华临床医师杂志(电子版) ›› 2017, Vol. 11 ›› Issue (18) : 2234 -2236. doi: 10.3877/cma.j.issn.1674-0785.2017.18.005

所属专题: 文献

临床论著

中枢性低钠血症在颅内感染诊治中的临床价值
樊琪1, 王超1, 崔玲伟1, 李腾宇1, 马定军1, 朱蔚东1,()   
  1. 1. 100020 北京中医药大学东直门医院东区神经外科
  • 收稿日期:2017-08-14 出版日期:2017-09-15
  • 通信作者: 朱蔚东

Value of central hyponatremia in diagnosis and treatment of intracranial infection

Qi Fan1, Chao Wang1, Lingwei Cui1, Tengyu Li1, Dingjun Ma1, Weidong Zhu1,()   

  1. 1. Department of Neurosurgery, Dongzhimen Hospital Eastern Affiliated to Beijing University of Chinese Medicine, Beijing 100020, China
  • Received:2017-08-14 Published:2017-09-15
  • Corresponding author: Weidong Zhu
  • About author:
    Corresponding author: Zhu Weidong, Email:
引用本文:

樊琪, 王超, 崔玲伟, 李腾宇, 马定军, 朱蔚东. 中枢性低钠血症在颅内感染诊治中的临床价值[J]. 中华临床医师杂志(电子版), 2017, 11(18): 2234-2236.

Qi Fan, Chao Wang, Lingwei Cui, Tengyu Li, Dingjun Ma, Weidong Zhu. Value of central hyponatremia in diagnosis and treatment of intracranial infection[J]. Chinese Journal of Clinicians(Electronic Edition), 2017, 11(18): 2234-2236.

目的

分析颅内感染合并中枢性低钠血症的临床特征,探讨中枢性低钠血症在颅内感染诊治中的临床价值。

方法

收集北京中医药大学东直门医院东区神经外科2013年1月至2017年1月收治的颅脑损伤手术治疗后合并低钠血症患者72例,根据是否发生颅内感染分为颅内感染组(40例)和非颅内感染组(32例),根据血清钠值将颅内感染组分为轻度、中度、重度低钠血症3组,采用t检验比较颅内感染组和非颅内感染组血清钠水平的差异。颅内感染的3组间脑脊液白细胞计数及葡萄糖浓度采用单因素方差分析进行比较,采用LSD-t检验进行3组间脑脊液白细胞计数的两两比较。

结果

颅内感染组血清钠水平显著低于非颅内感染组(t=2.66,P=0.0103),颅内感染组轻度、中度、重度低钠血症患者间脑脊液白细胞数、脑脊液葡萄糖浓度比较,差异具有统计学意义(F=47.47,P=4.63E-11;F=4.18,P=0.023),脑脊液白细胞计数采用LSD-t检验进行组间的两两比较,各组间差异均有统计学意义(P<0.05)。

结论

颅脑损伤术后合并颅内感染的患者更易出现低钠血症,血清钠水平越低颅内感染的严重程度越严重。

Objective

To investigate the clinical significance of central hyponatremia in the diagnosis and treatment of intracranial infection.

Methods

Seventy-two postoperative patients with craniocerebral injury complicated with central hyponatremia were collected at Department of Neurosurgery, Dongzhimen Hospital Eastern Affiliated to Beijing University of Chinese Medicine and divided into an intracranial infection group (40 cases) and a non-intracranial infection group (32 cases). Based on the level of serum sodium, the intracranial infection group was further divided into three subgroups (mild, moderate, and severe). Comparisons of serum sodium were made between the two groups by the t-test, and white blood cell (WBC) count and glucose in cerebrospinal fluid (CSF) were compared among different subgroups in the intracranial infection group by one-way analysis of variance.

Results

There was a statistical difference in serum sodium between the two groups (t=2.66, P=0.0103). There was also a statistical difference in WBC count and glucose in CSF glucose among different subgroups in the intracranial infection group (F=47.47, P=4.63E-11; F=4.18, P=0.023).

Conclusion

Intracranial infection severity is inversely related to central hyponatremia; the more severe intracranial infection, the lower serum sodium.

表1 颅内感染组轻、中、重度低钠血症间脑脊液白细胞数、脑脊液葡萄糖比较(±s
[1]
Reichert MC, Medeiros EA, Ferraz FA. Hospital-acquired meningitis in patients undergoing craniotomy: incidence, evolution, and risk factors [J]. Am J Infect Control, 2002, 30(3): 158-164.
[2]
Korinek AM, Gorge B, Haines SJ, et al. Risk factors for neurosurgical site infections after craniotomy: a prospective multicenter study of 2944 patients [J]. Neurosurgery, 1997, 41(5): 1073-1081.
[3]
王忠诚. 王忠诚神经外科学 [M]. 湖北: 湖北科学技术出版社, 2005: 919.
[4]
谭博, 刘绍明. 神经外科术后颅内感染危险因素分析研究 [J]. 中华神经外科疾病研究杂志, 2015,14(3): 283-285.
[5]
胡广卉, 赵保钢. 开颅术后颅内感染的治疗 [J]. 中华神经医学杂志, 2007, 23(6): 424.
[6]
Bracco D, Favre JB, Ravussin P. Hyponatremia in neurologic intensive care: cerebral salt wasting syndrome and inappropriate antidiuretic hormone secrtion [J]. Ann Fr Anesth Reanim, 2001, 20(2): 203-212.
[7]
王士强, 魏建功, 宋同均, 等. 重型颅脑损伤并低钠血症诊治分析 [J]. 中国实用医药, 2015, 10(14): 11-12.
[8]
练晓文, 陈建良, 游恒星, 等. 老年颅脑损伤后并发低钠血症的治疗体会 [J]. 中华全科医学, 2014, 10(12): 1580-1582.
[9]
Zhang W, Li S, Visocchi M, et al. Natriuretic peptides, antidiuretic hormone and hyponatraemia after acute craniocerebral injury [J]. J Int Med Res, 2008, 36(4): 648-655.
[10]
Espin EA, Leikis R, Ferch RD, et al. The neuron-cardio-endocrine response to acute subarachnoid haemorrhage [J]. Clin Endocrinol(Oxf), 2002, 56(5): 629-635.
[11]
McGirt MJ, Blessing R, Nimjee SM, et al. Correlation of serum brain natriuretic peptide with hyponatremia and delayed ischemie neurological deficits after subarachnoid hemorrohage [J]. Neurosurgery, 2004, 54(6): 1369-1374.
[12]
Sherlock M, O′Sullivan E, Agha A, et al. Incidence and pathophysiology of severe hyponatraemia in neurosurgical patients [J]. Postgrad Med J, 2009, 85(1002): 171-175.
[13]
Cuesta M, Hannon MJ, Thompson CJ. Diagnosis and treatment of hyponatraemia in neurosurgical patients [J]. Endocrinol Nutr, 2016, 63(5): 230-238.
[14]
Frey FJ. Hyponatraemia in patients with neurosurgical disorders: SIADH or cerebral salt wasting syndrome? [J]. Ther Umsch, 2009, 66(11): 769-772.
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