2007低钠血症指南.doc

2007 低钠血症指南 2010 年9 月第 30 卷第 9期中国实用内科杂志 2007 年低钠血症治疗指南王燕,顾锋提要: 低钠血症是临床上最为常见的电解质紊乱之一。由于引起低钠血症的原因很多, 患者常就诊于多个科室, 尤其以急诊科、呼吸科、肿瘤科、心脏内科、消化内科、神经科以及脑外科等临床科室最为常见。低钠血症的临床表现主要以神经系统功能障碍为主。根据低钠出现的缓急,神经系统的临床表现及预后有很大的差异。慢性低钠血症的临床表现症状缺乏特异性, 患者常常往返于多个科室而不被临床医师重视甚至误诊。尤其是一部分肺部恶性肿瘤的患者常常以低钠血症就诊, 若未及时诊治, 常常贻误诊断及治疗。急性、严重的低钠血症的病死率很高, 并且低钠血症能明显增加实质性疾病的病死率。故临床上应高度重视低钠血症的诊断以及病因的鉴别诊断, 并采取相应的措施纠正低钠血症, 去除病因。关键词: 低钠血症;抗利尿激素不恰当分泌综合征 Treatment guidelines for hyponatremia in 2007 . Summary : Hyponatremia is one of the mon disord er of electrolytes . Patients always need to go to many departments , especially clinical departments like emergency department , department of respiratory disease , department of oncology , department of cardiology , digestive system department , neurology department and thoracic surgery department in that hyponatremia is caused by many factors . Hyponatremia's clinical feature is mainly nerve system dysfunction . According to the urgency of hypontremia , there is significant difference in clinical feature and prognosis on nervous system . For the reason that chronic hyponatremia's clinical symptom lacks specificity , patients always need to go to SO many departments that they can ’t catch the clinical physicians ’ attention even leads to misdiagnosis . Particularly a part of patients ’ malignant tumor of lung is often treated 聃 hyponatremia . It can always lead to hindered diagnosis and treatment if these patients can ’t be treated correctly in time . The death rate of acute severe hyponatremia is very high . What ’S more , hyponatremia can increase the fatality rate of parenchymal disease significantly . Thus , we should pay great attention to the diagnosis of hyponatremia and differential diagnosis of cau — ses of disease and take relative measures to prevent the cau ses of disease SO as to heal hyponatremia . Keywords : hyponatremia ; SIADH 低钠血症是临床最为常见的电解质紊乱, 在住院患者中发生率可达 l5 % -30 %。尽管大多数低钠血症患者症状轻微, 但低钠血症的诊治在临床上是非常重要的, 这是因为: (1) 急性、严重的低钠血症可以导致极高的致死率; (2) 基础病变为广泛