Rothwell Sean P, Rosengren David J
Royal Brisbane and Women's Hospital, Queensland, Australia.
Wilderness Environ Med. 2008 Spring;19(1):42-4. doi: 10.1580/07-WEME-CR-116.1.
Exercise-associated hyponatremia is the most common medical complication of ultradistance exercise and is usually caused by excessive hypotonic fluid intake. We report a case of severe hyponatremia in a healthy male trekking the Kokoda Trail in the remote Southern Highlands of Papua New Guinea. A 43-year-old male collapsed and had a generalized seizure in the afternoon of the third day of a guided trek. He was evacuated the following morning and was found to have a serum sodium level of 107 mmol/L on arrival to hospital. The case highlights that a high index of suspicion is required to identify patients with exercise-associated hyponatremia. Early diagnosis and appropriate management is critical to avoid the potentially fatal consequences of severe hyponatremia. The diagnosis and treatment of exercise-associated hyponatremia is particularly challenging in the remote Papua New Guinea jungle. Education of trek leaders, medics, and trekkers in appropriate preventative measures and the rapid treatment of exercise-associated hyponatremia is essential to avoid recurrences of this life-threatening condition.
运动相关性低钠血症是超长跑运动最常见的医学并发症，通常由摄入过多低渗液体引起。我们报告一例在巴布亚新几内亚偏远的南部高地徒步科科达小径的健康男性发生严重低钠血症的病例。一名43岁男性在有向导的徒步旅行第三天下午晕倒并全身抽搐。第二天早上他被疏散，到达医院时发现血清钠水平为107 mmol/L。该病例强调，识别运动相关性低钠血症患者需要高度的怀疑指数。早期诊断和适当管理对于避免严重低钠血症的潜在致命后果至关重要。在巴布亚新几内亚偏远的丛林中，运动相关性低钠血症的诊断和治疗尤其具有挑战性。对徒步旅行领队、医护人员和徒步旅行者进行适当预防措施以及运动相关性低钠血症快速治疗的教育，对于避免这种危及生命状况的复发至关重要。
