老年脑血管病后遗症患者低钠血症临床研究

摘要

Objective We aimed to research on the causes of senile cerebrovascular disease sequela patients complicated with hyponatremia, to facilitate the treatment process of the intervention. Method 80 patients with cerebral vascular disease sequelae from January 2012 to December 2013 in our hospital ward neural department of internal medicine were taken as the research objects. In terms of hyponatremia, they were divided into two groups: 32 cases in low sodium group, 48 cases in normal group. The related factors were analyzed. Results The main influence factors of senile cerebrovascular disease sequela patients complicated with hyponatremia is old age, being bedridden, nasal feeding, unconsciousness, combined with tumor, with pneumonia or respiratory failure, incomplete cardiac function in coronary heart disease, poor nutrition. The above factors were representative index (P<0.05). The clinical manifestations were mainly fatigue, anorexia, increase of disturbance of consciousness which accounted for 68.75%, 65.63%, 59.38%respectively, according to the incidences of qualifying are fatigue, anorexia, exacerbation of disturbance of consciousness, weak pulse, nausea, vomiting, cold extremities, dizziness, irritability, delirium and seizures. 32 cases were found in a timely manner. With timely supplement of sodium, 30 patients with hyponatremia were corrected, 2 patients with recurrent hyponatremia finally complicated with multiple organ failure, pulmonary infection were died. Conclusion The figure of elderly patients with cerebral vascular disease sequela of hyponatremia incidence is still high, the causes and severity of sequelae, complications, survival status are closely related, and the clinical manifestations were not specific. As for intervention on high risk factors of high-risk patients, the monitoring is the main means of prevention and treatment.%目的：研究老年脑血管病后遗症患者并发低钠血症的原因，以利于治疗过程的干预。方法选择2012年1月-2013年12月入住我院干部病房神经内科的脑血管病后遗症患者80例作为研究对象，根据是否并发低钠血症分为2组，低钠组32例，正常组48例，对低钠血症发生的相关因素进行分析。结果老年脑血管病后遗症患者并发低钠血症的影响因素包括高龄、卧床、鼻饲、意识不清、合并肿瘤、合并肺炎或呼吸衰竭、合并冠心病、心功能不全、营养状况差（均P＜0.05）。临床表现按发生率高低排位依次是疲倦、厌食、意识障碍加重、恶心、呕吐、四肢发凉、头晕、烦躁、谵妄及抽搐，前3位分别为68.75%、65.63%、59.38%。32例均及时发现低钠血症，及时补充钠后得以纠正，2例因反复低钠血症，最后并发多器官功能衰竭、肺部感染等死亡。结论老年脑血管病后遗症患者低钠血症的发生率仍较高，发生的原因与后遗症严重程度、合并症、生存状态等具有密切的相关性，患者的临床表现无特异性，对高危因素进行干预、高危患者重点监测是预防和治疗的主要手段。