POSTOPERATIVE HYPONATREMIA - A PROSPECTIVE-STUDY
POSTOPERATIVE HYPONATREMIA - A PROSPECTIVE-STUDY
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DOI：
10.1001/archinte.146.2.333
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发表时间：
1986-02-01
影响因子：
--
通讯作者：
ANDERSON, RJ
中科院分区：
文献类型：
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作者：
CHUNG, HM;KLUGE, R;ANDERSON, RJ
在本研究中，我们发现1,088例前瞻性研究患者中至少有4.4%发生术后低钠血症（血浆钠浓度< 130 mEq/L）。大多数患者（42%）血容量正常。然而，水肿状态（21%）、高血糖（21%）、血容量不足（8%）和肾衰竭（8%）也是术后低钠血症的常见情况。血浆精氨酸加压素存在于所有患者中，它是测量和94%的患者接受低渗液时，发展为低钠血症。在本研究中，48例术后患者的低钠血症与显著的神经功能恶化无关。然而，在8例患者中，导致低钠血症的正水平衡与肺血管充血的发展相关。我们的结论是，低钠血症通常发生在所有类型的外科手术，是由于低渗液体管理的存在下，非渗透性分泌的精氨酸加压素。
In the present study, we found that at least 4.4% of 1,088 prospectively studied patients developed postoperative hyponatremia (plasma sodium concentration < 130 mEq/L). Most patients (42%) were normovolemic. Edematous states (21%), hyperglycemia (21%), volume depletion (8%), and renal failure (8%), however, were also common settings of postoperative hyponatremia. Plasma arginine vasopressin was present in all patients in whom it was measured and 94% of the patients were receiving hypotonic fluid at the time of development of hyponatremia. Hyponatremia was not associated with significant neurologic deterioration in the 48 postoperative patients in the present study. In eight patients, however, the positive water balance that resulted in hyponatremia was associated with development of pulmonary vascular congestion. We conclude that hyponatremia commonly occurs following all types of surgical procedures and is due to hypotonic fluid administration in the presence of nonosmotic secretion of arginine vasopressin.