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[医院内的高钠血症]

[Hypernatremia in hospital].

作者信息

Tagan Géraldine, Benmachiche Malik

机构信息

Service de médecine interne, Centre hospitalier universitaire vaudois, 1011 Lausanne.

出版信息

Rev Med Suisse. 2023 Nov 22;19(851):2189-2192. doi: 10.53738/REVMED.2023.19.851.2189.

Abstract

Hypernatremia, defined as a serum sodium concentration greater than 145 mmol/l, is an electrolyte disorder associated with increased in-hospital morbidity and mortality. Its prevalence is estimated between 1 to 3% in hospitalized patients and up to 11% in intensive care. It most often results from an impaired thirst mechanism or the inability to access water to drink. The clinical presentation varies depending on the severity of the hypernatremia. Patients may be pauci-symptomatic to comatose. Correcting too quickly the hypernatremia can lead to serious consequences (cerebral hemorrhage, demyelination). Prevention of the onset of hypernatremia is essential in the hospital. Its management consists of treating the underlying cause and correcting the hyperosmolarity by ensuring close monitoring of the sodium level.

摘要

高钠血症定义为血清钠浓度大于145 mmol/L,是一种与住院患者发病率和死亡率增加相关的电解质紊乱。据估计,住院患者中其患病率为1%至3%,在重症监护患者中高达11%。它最常由口渴机制受损或无法获取饮用水引起。临床表现因高钠血症的严重程度而异。患者可能症状轻微至昏迷。过快纠正高钠血症可能导致严重后果(脑出血、脱髓鞘)。在医院预防高钠血症的发生至关重要。其治疗包括治疗潜在病因并通过密切监测钠水平来纠正高渗状态。

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