Hellebostad M, Hågå P
Barneavdelingen, Ullevål sykehus, Oslo.
Tidsskr Nor Laegeforen. 1990 Jun 20;110(16):2066-7.
Acute water intoxication with hyponatraemic convulsions has been described several times in children less than two years old. We describe a two-day-old boy who developed hyponatraemia with convulsions because of water intoxication during his stay in the maternity ward. It was a hot day, and the baby was observed to sweat abundantly. The mother therefore breast fed him at frequent intervals and in addition offered him plain water, which he drank eagerly, approximately 350 ml in the course of a few hours. He then developed convulsions with bilateral clonic flexion movements of the arms, and serum sodium concentration was 113 mmol/l (114 on repeat). He was treated with diazepam and phenobarbitone and 20 mmol NaCl as slow infusion, and serum Na was 135 mmol/l after 20 hours. During treatment he passed large amounts of dilute urine and lost 110 g of weight. No abnormal loss of salt was found, and follow-up for six months has been uneventful. Neonates are at risk of developing hyponatraemia and convulsions when offered large amounts of electrolyte poor solutions, especially during hot weather.
急性水中毒伴低钠血症惊厥在两岁以下儿童中已有多次报道。我们描述了一名两天大的男婴，他在产科病房期间因水中毒而出现低钠血症伴惊厥。天气炎热，观察到婴儿大量出汗。因此，母亲频繁地给他喂奶，此外还给他喝白开水，他急切地喝了下去，几个小时内大约喝了350毫升。随后他出现惊厥，双臂有双侧阵挛性屈曲动作，血清钠浓度为113毫摩尔/升（复查时为114）。他接受了地西泮、苯巴比妥治疗，并缓慢输注20毫摩尔氯化钠，20小时后血清钠为135毫摩尔/升。治疗期间，他排出大量稀释尿液，体重减轻了110克。未发现异常失盐情况，随访六个月无异常。新生儿在摄入大量低电解质溶液时，尤其是在炎热天气下，有发生低钠血症和惊厥的风险。
