Miller P D, Krebs R A, Neal B J, McIntyre D O
Am J Med. 1982 Sep;73(3):354-6. doi: 10.1016/0002-9343(82)90726-4.
Hypernatremia in elderly patients is most often due to the patients mental incapacity or physical inability to obtain water despite intact thirst sensation. Hypodipsia leading to hypernatremia is not often considered in alert, elderly subjects since hypodipsia is not a recognized consequence of nonaphasia-producing cerebrovascular accidents. Described herein are six elderly patients who had such cerebrovascular accidents and who had recurrent hospitalizations for dehydration and hypernatremia. Hypernatremia in this group was due to hypodipsia and could only be prevented by prescribing daily fluid intake as a medication order. Hypodipsia should be considered as a cause of hypernatremia in elderly subjects even when they seem fully capable of requesting and obtaining water.
老年患者高钠血症最常见的原因是患者虽有正常的口渴感觉，但因精神或身体原因无法获取水分。在警觉的老年受试者中，导致高钠血症的饮水减少现象通常未被考虑，因为饮水减少并非非失语性脑血管意外的公认后果。本文描述了6例发生此类脑血管意外且因脱水和高钠血症反复住院的老年患者。该组患者的高钠血症是由饮水减少引起的，只有通过将每日液体摄入量作为医嘱来规定才能预防。即使老年受试者看起来完全有能力要求并获取水分，也应将饮水减少视为高钠血症的一个原因。
