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目的探讨重度颅脑损伤并发高钠血症的临床疗效。方法分析本院近年收治的重度颅脑损伤患者117例,将其分为高钠血症及非高钠血症两组,记录其哥拉斯哥昏迷评分(GSC),及患者病死率情况。结果高钠血症患者伤后1d内发生高钠血症6例,3d时检测出高钠血症11例,1w检测出l9例,平均血清钠水平为162.8mmol/L。两组GCS评分比较有显著性意义(P<0.05)。高钠血症组36例,死亡27例,生存9例,其中重残4例,中残2例。非高钠血症组81例,死亡32例,生存49例,其中重残11例,中残10例。死亡原因为呼吸道堵塞、呼吸道感染、脑疝、消化道感染。生存患者的平均血清钠水平为160.1mmol/L。死亡患者的平均血清钠水平为169.0mmol/L。死亡率比较两组具有显著性意义(P<0.005)。结论重度颅脑损伤并发高钠血症与患者的病情及GCS评分水平相关,伤情重则血钠高,并且生存率低。
Objective To investigate the clinical effect of severe cerebral injury complicated with hypernatremia. Methods 117 cases of severe traumatic brain injury admitted in our hospital in recent years were divided into two groups: hyperuricemia and non-hyperuricemia. The Glasgow Coma Scale (GSC) and case fatality rate were recorded. Results Hypernatremia was found in 6 cases of hypernatremia patients within 1d after injury, 11 cases of hypernatremia were detected at 3d and 1 case was detected at 1w. The mean serum sodium level was 162.8mmol / L. GCS score between the two groups was significant (P <0.05). 36 cases of hypernatremia group, 27 cases of death, 9 cases of survival, including 4 cases of severe disability, 2 cases of residual. 81 cases of non-hypernatremia group, 32 died, 49 cases of survival, including severe disability in 11 cases, 10 cases of residual. The cause of death is airway obstruction, respiratory tract infection, hernia, digestive tract infection. The mean serum sodium level of survivors was 160.1 mmol / L. The mean serum sodium level of patients who died was 169.0 mmol / L. Mortality in both groups was significant (P <0.005). Conclusions Severe traumatic brain injury complicated with hypernatremia is associated with the patient’s condition and GCS score. The injury severity is associated with high serum sodium and low survival rate.