肝硬化失代偿期合并低钠血症82例临床分析

摘要

Objective Discussion on the clinical efficacy of sodium treatment on patients with cirrhosis in the liver decompensation period complicated with hyponatremia .Methods Eighty two cases of cirrhosis with hyponatre-mia from 2010 March to 2012 June in our hospital were chose to be subjects ,then all the cases were divided into the light group ,the medium group and the severe group according to the serum sodium concentration ,the three groups included cases respectively 36 ,29 ,17 ,all the cases were gave an appropriate supplement of sodium .Results The ser-um sodium concentration of the patients in three groups were significantly increased compared to that before sodium treatment ,there was significant difference between the serum sodium concentration before and after treatment (P<0 .05) ,31cases in the light group were improved markedly after treatment with the efficiency rate 86 .11% ,22 cases in the mild group were improved markedly after treatment with the efficiency rate 75 .86% ,4 cases in the severe group were improved markedly after treatment 25 .53% ,The more serious the hyponatremia ,the lower efficiency of treatment show ,there was no significant difference in efficiency between the light group and the medium group (P>0 .05) ,severe hyponatremia group had significant differences with other groups in the efficiency (P<0 .05) .Conclu-sion Patients with cirrhosis in the liver decompensation period with mild to moderate hyponatremia can be effective-ly correct ,but for severe hyponatremia patients complement high sodium method is not ideal ,which implies for hy-ponatremia patients ,early detection ,timely intervention can improve the prognosis .%目的：探讨肝硬化失代偿期合并低钠血症患者补充钠盐治疗的临床疗效。方法选取2010年3月至2012年6月解放军302医院收治的82例肝硬化合并低钠血症患者作为研究对象，根据血钠浓度将所选患者分为轻、中、重3组，分别为36、29、17例，对不同组别采用不同补钠治疗，并比较各组的治疗效果。结果3组患者采用补钠治疗后的血钠浓度相比于补充钠盐之前均明显上升，治疗前后比较差异有统计学意义（P＜0．05）；轻度低钠血症组补钠治疗后显效31例，显效率为86．11％；中度低钠血症组显效22例，显效率为75．86％；重度低钠血症组显效4例，显效率为23．53％；轻度低钠血症组显效率最高，中度低钠血症组显效率次之，重度低钠血症组显效率最低。轻度低钠血症组与中度低钠血症组显效率差异无统计学意义（P＞0．05），重度低钠血症组显效率与轻度低钠血症组及中度低钠血症组比较差异有统计学意义（P＜0．05）。结论肝硬化失代偿期合并轻中度低钠血症患者补钠能有效纠正，但重度低钠血症患者应用补充高张钠的方法疗效仍不理想，提示对于低钠血症的早期发现、及时干预可以改善预后。