目的 探讨限水试验结合补液试验对前交通动脉瘤破裂术后脑性盐耗综合征的治疗价值.方法 回顾性分析2010年1月至2017年12月本院收治的前交通动脉瘤破裂实施手术治疗后出现血钠水平紊乱患者80例.按照治疗方法分为两组,每组40例.观察组实施限水试验结合补液试验进行诊断后针对性进行补液、维持电解质稳定,对照组则以对症支持处理为主,主要通过检测患者水、电解质变化,及时进行补充与维持.比较两组血钠、尿钠恢复正常时间及住院时间,两组治疗期间出现的并发症.结果 观察组血钠、尿钠恢复正常时间及住院时间均显著短于对照组(P＜0.05),治疗过程中观察组出现肺部感染、脑积水、肝功能衰竭及肾功能衰竭的总发生率显著低于对照组(P＜0.05).结论 针对前交通动脉瘤破裂术后盐耗综合征,顽固性低钠血症者,实施补液试验结合限水试验,能更好地促进血钠恢复正常,减少治疗并发症,缩短住院时间.%Objective To investigate the therapeutic value of water limited test combined with fluid replacement test in cerebral salt wasting syndrome after surgery for anterior communicating aneurysm rupture.Methods 80 cases with blood-sodium level disorder after surgery for anterior communicating aneurysm rupture from January 2010 to December 2017 were divided into two groups,40 cases in each group.The observation group were given water limited test combined with fluid replacement test,while the control group was mainly treated with symptomatic support,detecting changes in water and electrolytes and timely supplementing and maintaining.The time of blood sodium,urine sodium returning to normal,hospitalization time,and complications of the two groups were compared.Results The time of blood sodium,urine sodium returning to normal and hospitalization time in the observation group were shorter than those in the control group (P＜0.05),and the total incidence of complications (pulmonary infection,hydrocephalus,liver failure,and renal failure) of the observation group was lower than that of the control group (P＜0.05).Conclusion For patients with cerebral salt wasting syndrome and refractory hyponatremia after surgery for rupture of anterior communicating aneurysm,water limited test combined with fluid replacement test can better promote the recovery of blood sodium,reduce treatment related complications,and shorten hospital stay.
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