Value of central hyponatremia in diagnosis and treatment of intracranial infection

doi:10.3877/cma.j.issn.1674-0785.2017.18.005

Abstract

Abstract:

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.

Key words: Craniocerebral injury, Intracranial infection, Hyponatremia, Cerebrolspinal fluid

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.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhlcyszz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-0785.2017.18.005

https://zhlcyszz.cma-cmc.com.cn/EN/Y2017/V11/I18/2234

Figures/Tables 1

References 14

[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.

组别	例数	标本（份）	Csf-WBC（个/μl）	Csf-glu（mmol/L）
轻度	11	25	455.9±372.9	2.78±1.06
中度	19	61	1079.1±829.4	2.01±1.21
重度	10	24	5156.2±2201.8	1.27±1.06
F值	?	?	47.47	4.18
P值	?	?	<0.001	0.023

组别	例数	标本（份）	Csf-WBC（个/μl）	Csf-glu（mmol/L）
轻度	11	25	455.9±372.9	2.78±1.06
中度	19	61	1079.1±829.4	2.01±1.21
重度	10	24	5156.2±2201.8	1.27±1.06
F值	?	?	47.47	4.18
P值	?	?	<0.001	0.023

[1]	Xiaowei Wang, Yelai Wang, Yuhang Xu, Huayong Zheng, Jianzheng Zhang, Zhi Liu, Tiansheng Sun. Correlation of serum sodium disorder with mortality after hip fracture in elderly patients [J]. Chinese Journal of Joint Surgery(Electronic Edition), 2023, 17(02): 186-194.
[2]	Yong Zheng, Lei Zhou, Zongpei Guo. Expression of apoptosis-induced mitochondrial protein and astrocyte-derived protein of patients with infection after craniocerebral injury [J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2020, 14(04): 296-300.
[3]	Yuhui Chen, Jiaxing Wang, Jun Tian, Liangfeng Wei, Shousen Wang. Surgical treatment of craniocerebral firearm injury with clinical anlysis of 4 cases [J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2022, 08(01): 47-50.
[4]	Changdong Li, Jie Zhou, Zhibiao Cai, Kai Wang. Effects of isoliquiritigenin on the expression of MMP-9 and TIMP-1 protease after brain injury in rats [J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2021, 07(04): 199-202.
[5]	Hailin Huang, Xiaoyi Wang, Gang Cheng, Dapeng Ma, Zongping Li. Risk factors of intracranial infection after craniotomy for nterior communicating aneurysm clipping and the diagnostic value of UA and LDH in serum and cerebrospinal fluid [J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2021, 07(04): 247-251.
[6]	Shenghua Lu, Zhigang Zhao, Xuejiao Wang, Chonghao Wang, Runfa Tian, Linlin Wang, Jing Li, Fei Niu, Bin Zhang, Baiyun Liu. Clinical observation of "three-step disinfection" on reducing intracranial infection rate after ventriculo peritoneal shunt [J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2021, 07(02): 107-111.
[7]	Shengcai Gu, Xiang Mao, Xuefeng Tian, Hongwei Cheng. Clinical effect analysis of continuous lumbar cistern drainage combined with intrathecal injection of gentamicin on intracranial infection after ventricular hemorrhage [J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2021, 07(02): 100-102.
[8]	Zhonghua Wu, Liansheng Long, Xialiang Li, Wei Wang, Shunxiao Shi, Wenjie Fang, Hu Xie, Zhicheng Xin, Chaochao Jiang, Wenguo Sheng, Xiaomin Yu. Significance of skull base exploration and reconstruction in craniotomy of acute traumatic brain injury [J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2021, 07(02): 96-99.
[9]	Yang Cui, Zhangli Wang. Risk factors of delayed intracranial hematoma after craniocerebral trauma surgery [J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2021, 07(02): 87-91.
[10]	Weili Liu, Yuyan Zhang, Lijun Meng, Xufeng Wu, Wenjie Yuan, Yucheng Li, Guangfa Wei, Rui Yuan. Establishing an novel prognostic model of patients with craniocerebral injury by artificial neural network [J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2021, 07(04): 355-359.
[11]	Ning Liu, Shaohui Chao, Jieqiong Lin, Jianhui Jin, Rong Qin. Pathogenic characteristics and risk factors of pulmonary infection in patients with craniocerebral injury after intracranial infection [J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2020, 06(03): 296-300.
[12]	Chen Chen, Hong Xu, Zheng Li, Yangyun Han. Study on the application of intraventricular intracranial pressure monitoring in perioperative period of patients with severe craniocerebral injury [J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2022, 12(03): 146-151.
[13]	Xiaojun Ji, Xiaodong Zhai, Xiaofang Li, Peilin Zhao, Senhui Yue, Yueming Zhang. Therapeutic effect of tigecycline on intracranial infection of extensively drug-resistant Acinetobacter baumannii by dual approach [J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2022, 12(02): 85-89.
[14]	Xin Zhang, Jianyun Zhou, Ze Cao, Wei Sun. Clinical effects of minimally invasive ventriculoperitoneal shunting [J]. Chinese Journal of Clinicians(Electronic Edition), 2021, 15(12): 917-921.
[15]	Zhenxiao Sun, Huaxue Liu, Deju Ren. Diagnostic features and literature review of polydipsia, intermittent hyponatremia and psychosis syndrome [J]. Chinese Journal of Diagnostics(Electronic Edition), 2022, 10(04): 266-269.

Please choose a citation manager

Content to export