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 disorder of
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 's clinical feature is mainly nerve system to the urgency of hypontremia,
there is significant difference in clinical feature and prognosis on nervous
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 a part of patients’malignant tumor of lung is often can always lead to hindered diagnosis and treatment if these patients can’t be treated correctly in death rate of acute severe hyponatremia is very
’S more,hyponatremia can increase the fatality rate of parenchymal disease ,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 causes 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)基础病变为广泛的实质性疾病的患者,若伴有低钠血症病死率会更高;(3)过度快速纠正慢性低钠血症可以引发严重的神经性病变和死亡