【摘要】 目的:探讨急性颈髓损伤后低渗血症的相关因素及治疗方法。方法:1998年10月￣2002年2月共收治114例急性颈髓损伤患者,其中完全性颈髓损伤患者42例(A组);不完全性颈髓损伤72例(B组);同期收治的不伴颈髓损伤的其它损伤患者41例(C组)。测定各组患者的血浆渗透压、Na+、K+、Cl-、Ca2+、二氧化碳结合力(CO2CP)、血糖(Glu)、血尿素氮(Bun)、血浆蛋白质总量(TP)、白蛋白(ALB)及球蛋白(GLB)含量。对42例完全性颈髓损伤患者中35例严重低钠血症患者(血钠=120￣125mmol/L)20例每天采用3%氯化钠盐水400ml静脉点滴(D组),15例每天采用3%氯化钠盐水400ml加血浆200ml静脉点滴(E组)进行1周治疗。结果:A、B、C三组间血浆渗透压、Na+、Cl-、TP及ALB、GLB含量存在显著性差异(P<0.05)。D、E组间治疗效果存在显著性差异(P<0.05),E组优于D组。结论:急性颈髓损伤易并发低渗血症,其发生率与损伤的程度、低钠及低蛋白有关。同时补充盐和血浆治疗效果较好。更多还原

【Abstract】 Objective:To analyze correlative factors and its treatment of hyponatremia in acute cervical spinal cord injury.Method:114 patients between October 1998 and February 2002 with acute cervical spinal cord injury were included.Of the patients,42 cases(group A) had completed cervical spinal cord injury,72 cases(group B) had incompleted cervical spinal cord injury,and 41 cases(group C) with no spinal cord injury.The electrolytic concentrations and protein concentrations including Na+,K+,Cl-,CO2-CP,Glu,Bun,Ca2+,TP,ALB,and GLB were measured.Of 35 cases who suffered from severe hyponatremia(Na+ 120-125mmol/L),20 cases(group D) were treated by 3% NaCl saline 400ml through injected intravenously,15 cases(group E) were treated by 3% NaCl saline 400ml+200ml blood plasm through injected intravenously with the duration of one week.Result:Their were siganificant difference(P<0.05) among group A,B and C in Na+,Cl-,TP,ALB,and GLB as well as group D and E(P<0.05).The hyponatremia was correlated well with Na+,Cl- and TP.Conclusion:The occurrence rate of the hyposmolality in acute cervical spinal cord injury have something to do with degrees of spinal cord injury and have nothing to do with the segment of spinal cord injured.The hyposmolality in acute cervical spinal cord injury caused by hyponatremia and hypoprotein in blood can be corrected by suppling both electrolytic solution and blood plasm.更多还原