Department of Neurology, Mayo Clinic, 200 First Street, SW-Mayo W8B, Rochester, MN 55905, USA.
Neurocrit Care. 2011 Sep;15(2):354-60. doi: 10.1007/s12028-011-9585-9.
Hyponatremia is the most common electrolyte imbalance seen in patients with aneurysmal subarachnoid hemorrhage, occurring in one-third to one-half of patients. Hyponatremia may be caused by cerebral salt wasting and by the syndrome of inappropriate secretion of antidiuretic hormone or a combination of both. Limited data are available describing hyponatremia treatment in subarachnoid hemorrhage patients. A Medline search was performed for English-language manuscripts describing original research in the treatment for hyponatremia in patients with aneurysmal subarachnoid hemorrhage. Seven appropriate articles were identified as followed: three testing fludrocortisone, two hydrocortisone, and one each for hypertonic saline and 5% albumin. Data quality for treatment efficacy and safety were moderate for corticosteroid studies and low or very low for hypertonic saline and 5% albumin. Available data, although limited, support early treatment with corticosteroids to limit hyponatremia, with fludrocortisone causing fewer side effects.
低钠血症是蛛网膜下腔出血患者中最常见的电解质失衡，发生率为三分之一至一半。低钠血症可能由脑性盐耗综合征和抗利尿激素分泌不当综合征引起，或两者兼有。目前可用的描述蛛网膜下腔出血患者低钠血症治疗的数据有限。我们对描述治疗脑动脉瘤性蛛网膜下腔出血患者低钠血症的原创研究的英文文献进行了 Medline 检索。确定了以下 7 篇合适的文章：3 篇测试氟氢可的松，2 篇测试氢化可的松，1 篇测试高渗盐水，1 篇测试 5%白蛋白。皮质类固醇研究的治疗效果和安全性数据质量为中等，高渗盐水和 5%白蛋白的数据质量为低或极低。虽然数据有限，但支持早期使用皮质类固醇治疗以限制低钠血症，氟氢可的松引起的副作用更少。
