急性重症脑卒中患者高钠血症发生情况及其与肾功能和预后的关系

发布时间：2018-04-09 22:40

本文选题：急性重症脑卒中　切入点：高钠血症　出处：《山东医药》2016年36期

【摘要】：目的探讨高钠血症对急性重症脑卒中患者肾功能、预后的影响。方法研究对象为98例急性重症脑卒中患者,基底核21例,脑干16例,丘脑27例,脑叶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。患者入院时及入院后第1天、第3天、第7天检测血钠水平,分析血纳水平与急性肾损伤(AKI)、预后的关系。结果本组28例患者出现高钠血症(发生率为28.6%),轻度、中度、中度者分别为12例、10例、6例,共发生AKI 12例;中度、重度高钠血症者AKI发生率明显高于非高钠血症患者,重度高钠血症患者AKI发生率明显高于轻度患者(P均0.05);中度、重度高钠血症病死率明显高于非高钠血症、轻度高钠血症患者,重度高钠血症死亡率亦明显高于中度患者(P0.05);存活者入院时、入院后第1、3、7天血钠水平均明显低于死亡者(P均0.05)。结论急性重症脑卒中患者高钠血症发生率较高,血钠增高程度越重,预后越差。积极预防和控制高钠血症有助于降低AKI发生率和病死率,改善预后。
[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.
【作者单位】：启东市人民医院;
【分类号】：R743.3

【相似文献】