發(fā)布時間：2018-04-09 22:40

  本文選題：急性重癥腦卒中　切入點(diǎn)：高鈉血癥　出處：《山東醫(yī)藥》2016年36期

【摘要】：目的探討高鈉血癥對急性重癥腦卒中患者腎功能、預(yù)后的影響。方法研究對象為98例急性重癥腦卒中患者,基底核21例,腦干16例,丘腦27例,腦葉34例。入院7天死亡15例(第1天0例,第3天4例,第7天11例),存活83例�；颊呷朐簳r及入院后第1天、第3天、第7天檢測血鈉水平,分析血納水平與急性腎損傷(AKI)、預(yù)后的關(guān)系。結(jié)果本組28例患者出現(xiàn)高鈉血癥(發(fā)生率為28.6%),輕度、中度、中度者分別為12例、10例、6例,共發(fā)生AKI 12例;中度、重度高鈉血癥者AKI發(fā)生率明顯高于非高鈉血癥患者,重度高鈉血癥患者AKI發(fā)生率明顯高于輕度患者(P均0.05);中度、重度高鈉血癥病死率明顯高于非高鈉血癥、輕度高鈉血癥患者,重度高鈉血癥死亡率亦明顯高于中度患者(P0.05);存活者入院時、入院后第1、3、7天血鈉水平均明顯低于死亡者(P均0.05)。結(jié)論急性重癥腦卒中患者高鈉血癥發(fā)生率較高,血鈉增高程度越重,預(yù)后越差。積極預(yù)防和控制高鈉血癥有助于降低AKI發(fā)生率和病死率,改善預(yù)后。
[Abstract]:Objective to investigate the effect of hypernatremia on renal function and prognosis in patients with acute severe stroke.Methods 98 patients with acute severe stroke were studied, including 21 cases of basal nucleus, 16 cases of brain stem, 27 cases of thalamus and 34 cases of lobes.Fifteen patients died on day 7 (0 on day 1, 4 on day 3, 11 on day 7) and 83 survived.Blood sodium levels were measured on admission and on day 1, day 3 and day 7 after admission, and the relationship between blood sodium level and prognosis of acute renal injury was analyzed.Results the incidence of hypernatremia in 28 patients (28. 6%), mild, moderate and moderate (10 cases, 6 cases, 12 cases), the incidence of AKI in patients with moderate and severe hypernatremia was significantly higher than that in patients with non hypernatremia.The incidence of AKI in patients with severe hypernatremia was significantly higher than that in patients with mild hypernatremia (P < 0.05), the mortality of moderate and severe hypernatremia was significantly higher than that of patients with non-hypernatremia.The mortality rate of severe hypernatremia was also significantly higher than that of moderate patients (P 0.05), and the serum sodium levels in survivors were significantly lower than those in the dead patients on the 7th day after admission at the 1st day of admission (P 0.05).Conclusion the incidence of hypernatremia in patients with acute severe stroke is higher.Active prevention and control of hypernatremia can reduce the incidence and mortality of AKI and improve prognosis.
【作者單位】： 啟東市人民醫(yī)院;
【分類號】：R743.3

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