Wattad A, Chiang M L, Hill L L
Department of Pediatrics, Baylor College of Medicine, Houston, Texas.
Clin Pediatr (Phila). 1992 Mar;31(3):153-7. doi: 10.1177/000992289203100305.
To determine the frequency, causes, and clinical significance of hyponatremia in hospitalized children, we reviewed the clinical and laboratory data of all hyponatremic children in Texas Children's Hospital over a 12-month period. One hundred sixty-one patients from among 11,702 hospital admissions were found to have hyponatremia, defined as serum sodium value of less than 130 mEq/L, an overall frequency of 1.38%. Sixty-nine patients (43%) had hyponatremia on admission, and 92 patients (57%) had hospital-acquired hyponatremia. Thirty-seven (23%) were previously healthy children, and 124 (77%) had chronic illnesses. Acute gastroenteritis was the leading cause of hyponatremia present on admission, and diuretic therapy was the leading cause of hospital-acquired hyponatremia. Only four patients (2.5%) had a serum sodium concentration of less than 120 mEq/L. Six patients (3.7%) had neurologic impairment on discharge, and 19 patients (12%) ultimately died long after their hyponatremia was corrected. Each patient who had neurologic sequelae and each patient who died had underlying medical conditions which could explain their morbidity and/or mortality. The prognosis appears to be more clearly related to the underlying medical disorder rather than to the hyponatremic state or its correction.
为了确定住院儿童低钠血症的发生率、病因及临床意义，我们回顾了德州儿童医院12个月期间所有低钠血症患儿的临床和实验室数据。在11702例住院患儿中，有161例被发现患有低钠血症，定义为血清钠值低于130 mEq/L，总发生率为1.38%。69例（43%）患儿入院时即有低钠血症，92例（57%）为医院获得性低钠血症。37例（23%）为既往健康儿童，124例（77%）患有慢性疾病。急性胃肠炎是入院时低钠血症的主要原因，利尿剂治疗是医院获得性低钠血症的主要原因。只有4例（2.5%）患儿血清钠浓度低于120 mEq/L。6例（3.7%）患儿出院时存在神经功能损害，19例（12%）患儿在低钠血症纠正很久后最终死亡。每例有神经后遗症的患儿和每例死亡患儿都有潜在的基础疾病，这些疾病可以解释他们的发病和/或死亡。预后似乎更明显地与潜在的基础疾病有关，而不是与低钠血症状态或其纠正情况有关。
